1 

N864 

1883 


Cbe  Hbrarp 

of  tt)e 

SZXtot0ion  of  J£>ealt&  affairs 
CJntoetsltp  of  JBortf)  Carolina 


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b2 

North  Carolina 
State  Board  of  Health 


This  BOOK  may  be  kept  out  TWO  WEEKS 
ONLY,  and  is  subject  to  a  fine  of  FIVE 
CENTS  a  day  thereafter.  It  was  taken  out  on 
the  day  indicated  below: 


Digitized  by  the  Internet  Archive 
in  2018  with  funding  from 
University  of  North  Carolina  at  Chapel  Hill 


https://archive.org/details/reportofproceedi00nort_0 


gap; 


REPORT  OF  PROCEEDINGS 


PUBLIC  HEALTH^RARY 

N.  C.  STATE  B0VF  HEALTH 
RALEIGH. 

F I  RS  T  AN  XTKYI,  CONVENTION 


OF  THE 


oriH  arolina  an 


association, 

i  «.  •  7 |- 


HELD  AT 


RALEIGH, 


6t)-bL  a xa cl  VLlX;,  i889. 


RALEIGH: 

Edwards  &  Broughton,  Power  Printers  and  Binders. 

•  1889,  .  .  . 


REPORT  OF  PROCEEDINGS 


OF  THE 

FIRST  ANNUAL  CONVENTION 


Field  at  raleigh, 


F^eloruiary  6ttn  and  7tli,  1889. 


RALEIGH,  N.  C.  : 

Edwards  &  Broughton,  Printers  and  Binders. 

1889. 


president: 


Hon.  A.  A.  THOMPSON, 
Raleigh,  N.  C. 


VICE-PRESIDENTS : 


Hon.  J.  J.  Fowler,.-. . . . . Wilmington,  N.  C. 

W.  E.  Fountain,  Esq  , _ Tarboro.  N.  C. 

E.  B.  Neave,  Esq., . . Salisbury,  N.  C. 


SECRETARIES: 


Dr.  Julian  M.  Baker, . Tarboro,  N.  C. 

J.  C.  Chase,  Esq., . Wilmington,  N.  C. 


EXECUTIVE  COMMITTEE: 


Dr.  Eugene  Grissom, 
Mr  J.  L.  Ludlow,... 

Dr.  W.  P.  Beall, _ 

Dr.  T.  F.  Wood _ 

Dr.  R.  H.  Lewis, _ 


. Raleigh, 

N. 

C. 

_ _  Winston, 

N. 

C. 

..  .Greensboro, 

N. 

c. 

-  -  Wilmington, 

N. 

c. 

. .  Raleigh, 

N. 

c. 

CALL  FOR  A  SANITARY  CONVENTION, 


TO  BE  HELD  IN 


Raleigh,  N.  C.,  on  Wednesday,  February  6th,  1889. 


The  interests  appertaining  to  the  public  health  are  of  such 
increasing  importance  that  its  demands  can  no  longer  go 
unheeded  by  the  general  public.  The  time  has  come  when 
men  of  all  professions  who  have  given  the  subjects  of  pub¬ 
lic  and  private  sanitation  any  consideration  should  assem¬ 
ble  to  interchange  views,  and  begin  in  earnest  the  study  of 
the  living  questions  which  concern  healthy  homes  and 
healthy  towns. 

^  1.  Many  towns  in  the  State  have  reached  a  condition  of 

'^progress  which  have  brought  them  face  to  face  with  the 
^problems  of  sewerage  and  water  supply,  involving  vast 
\^ums  of  money  and  the  future  health  of  unborn  thousands. 

2.  Our  State  has  numerous  locations,  the  merits  of  which 
.-4* are  attracting  the  attention  of  physicians  and  invalids  in 


S^manv  States  North  and  West,  and  these  must  be  studied  by 
*  us  with  definite  purpose  and  concerted  effort,  that  we  may 
^present  the  public  with  authoritative  statements  as  to  the 
^actual  condition  of  our  unoccupied  sanitaria. 

3.  The  questions  involved  by  the  appearance  now  and 
^then  of  pestilential  diseases  in  States  so  intimately  bound  to 
V  us  by  railroad  communication  that  their  cause  is  our  cause 
^ in  a  philanthropic  as  well  as  a  business  sense,  that  we  must 
sVstudy  them  and  discuss  them  in  order  to  disarm  these  epi- 

demies  of  their  greatest  dangers,  and  to  quell  the  panics 
•a  that  do  more  harm,  if  possible,  than  the  pestilence. 

4.  The  interests  of  the  public  health  of  the  State,  while  of 
necessity,  at  this  stage  of  its  development,  intrusted  to  the 


4 


CALL  FOR  A  SANITARY  CONVENTION. 


medical  profession,  must  be  dependent  for  its  vitality  upon 
the  interest  the  general  public  takes  in  it,  for  it  is  the  cause 
of  the  people.  A  convention,  therefore,  of  the  representa¬ 
tives  of  the  people,  officials  cognizant  of  the  defects  of  the 
sanitation  of  our  houses  and  towns  and  institutions,  and 
private  citizens  who  have  been  studying  with  interest,  and 
practicing  with  all  the  lights  they  have,  the  minutke  of 
health  laws,  is  a  potent  way  of  disseminating  information 
and  of  studying  our  defects  and  the  ways  to  remedy  them. 

For  these  and  many  other  considerations,  we,  the  under¬ 
signed,  deem  it  appropriate  to  call  a  Sanitary  Convention, 
to  meet  in  Faleigli  on  Wednesday,  the  6th  day  of  February, 
1889,  asking  that  a  good  attendance  may  be  had  of  county 
superintendents  of  health  and  other  officials  intrusted 
with  the  supervision  of  the  public  health,  and  of  farmers, 
lawyers,  doctors,  ministers,  civil  and  mining  engineers,  may¬ 
ors  of  towns,  chairmen  and  members  of  the  boards  of 
county  commissioners,  Superintendents  of  asylums  for  the 
insane  and  indigent,  officers  in  charge  of  hospitals  and  pen¬ 
itentiaries,  school-teachers,  railroad  officials,  and  every  citi¬ 
zen  interested  in  the  present  and  future  health  of  our  com¬ 
munities  and  homes. 

After  organization  the  following  topics  will  be  presented  : 

“How  can  we  best  secure  economical  disposal  of  refuse  in 
our  towns  ?  ” 

“  The  prospects  ol  the  future  water  supply  in  our  larger 
towns.” 

“  Some  of  the  facts  concerning  the  Sanitaria  in  our  State” 

“What  is  being  done  towards  providing  healthful  school- 
houses  in  the  smaller  towns  and  the  country?  ” 

“  How  can  we  establish  a  Bureau  of  Arital  Statistics,  that 
we  may  put  on  record  for  our  guidance  and  information  the 
destiny  of  the  population  as  regards  births,  diseases,  deaths, 
and  the  history  of  epidemics  dangerous  to  the  public  health  ?  ” 

“  Our  inland  and  maritime  quarantine.” 


CALL  FOR  A  SANITARY  CONVENTION. 


5 


\\  hat  is  needed  to  sustain  the  efforts  of  the  North  Caro¬ 
lina  Board  of  Health  ?  ” 

The  undersigned  unite  in  the  above  call  fully  appreciating 
the  great  benefits  which  may  result  to  the  health  of  the  peo¬ 
ple  by  a  full  exchange  of  thoughts,  and  earnestly  bespeak  a 
full  representation. 

Hon.  John  J.  Fowler,  Mayor  of  Wilmington. 

Julian  M.  Baker,  M.  D.,  Superintendent  of  Health, 
Edgecombe  County. 

Thomas  F.  Wood,  M.  I).,  Secretary  N.  C.  Board  of  Health, 
Wilmington. 

R.  N.  Williams,  Esq.,  Chairman  of  County  Commission¬ 
ers,  Edgecombe  County. 

Hon.  William  E.  Fountain,  Mayor  of  Tarboro. 

George  Gillett  Thomas,  M.  D.,  Member  of  Quarantine 
Board,  Cape  Fear  River. 

W.  G.  Curtis,  M.  D.,  Quarantine  Physician,  Southport. 

J.  W.  Jones,  M.  D.,  President  N.  C.  Board  of  Health. 

H.  T.  Bahnson,  M.  D.,  Salem,  Member  of  N.  C.  Board  of 
Health. 

J.  H.  Tucker,  M.  D.,  Henderson,  Member  of  N.  C  Board 
of  Health. 

J.  L.  Ludlow,  C.  E.,  Winston,  Member  of  N.  C.  Board  of 
Health. 

Hon.  Chas.  Beaufort,  Mayor  of  Winston. 

,  E.  B.  Borden,  Esq.,  Chairman  of  County  Commissioners, 
Wayne  County. 

J.  C.  Chase,  C.  E.,  Supt.  the  Clarendon  Water  W orks  Co., 
Wilmington,  N.  C. 

Hon.  J.  E.  Peterson,  Mayor  of  Goldsboro. 

Thomas  Hill,  M.  D.,  Coroner  of  Wayne  County. 

Prof.  F.  P.  Venable,  University  of  North  Carolina. 

Prof.  W.  J.  Martin,  Davidson  College. 

Hon.  E.  B.  Neave,  Mayor  of  Salisbury. 

T.  J.  Sumner,  Esq.,  Chairman  of  County  Commissioners, 

Rowan  County. 


CALL  FOR  A  SANITARY  CONVENTION. 


6 


J.  J.  Summerell,  M.  D.,  Superintendent  of  Health,  Rowan 
County. 

W.  T.  Ennett,  M.  D.,  Superintendent  of  Health,  Pender 
County,  and  President  N.  C.  Medical  Society. 

H.  B.  Battle,  Ph.  IX,  Director  N.  C.  Agricultural  Expe¬ 
riment  Station,  Raleigh. 

John  McDonald,  M.  D.,  Member  of  N.  C.  Board  of  Health. 

Hon.  A.  A.  Thompson,  Mayor  of  Raleigh. 

Richard  H.  Lewis,  M.  D.,  Member  of  N.  C.  Board  of 
Health. 

James  McKee,  M.  D.,  Superintendent  of  Health,  Wake 
County. 

W.  P.  Beall,  M.  D.,  Greensboro. 

Prof.  W.  G.  Simmons,  Wake  Forest. 

Fletcher  R.  Harriss,  M.  D.,  Superintendent  Health, 
Vance  County. 

W.  G.  Freeman,  M.  D.,  Murfreesboro. 

Hon.  Thos.  W.  Goodrich,  Mayor  of  Henderson. 

And  many  others. 


nvcxisrxjTEs 


OF  THE 

SANITARY  CONVENTION, 

Assembled  6tii  February,  1881). 
RALEIGH,  N.  Q 


The  meeting  was  called,  to  order  in  the  Mayor’s  room  by 
Mayor  A.  A.  Thompson,  member  of  the  Committee  of 
Arrangements,  at  10:  30  o’clock  a.  m. 

Prayer  was  offered  by  the  Rev.  Dr.  Watkins. 

Gov.  D.  G.  Fowle  honored  the  Convention  with  his  pres¬ 
ence,  and  delivered  a  very  spirited  address  of  welcome  to 
the  capital.  After  declaring  his  approbation  of  the  objects 
of  the  Convention,  he  said:  I  want  to  call  the  attention  of 
this  Convention  to  one  matter  in  particular  :  The  Governor 
of  Alabama,  under  a  resolution  passed  by  the  Legislature  ot 
that  State,  has  appointed  a  convention  to  be  held  at  Mont¬ 
gomery,  on  the  5th  of  March,  1880,  for  the  purpose  of  adopt¬ 
ing  certain  quarantine  regulations  for  the  benefit  and  pro¬ 
tection  of  the  Southern  States.  At  his  request  1  have 
appointed  a  committee  to  be  there,  and  I  would  ask  you  to 
designate  certain  gentlemen  who  would  be  acceptable  to 
them  to  represent  North  Carolina  in  that  quarantine  conven¬ 
tion,  and  a  commission  will  be  issued  by  the  Executive  of 
North  Carolina  to  go  as  accredited  representatives  of  tho 
State  to  every  man  designated  by  this  Convention,  even  if 

it  should  be  to  the  number  of  fifty. 

I  believe  that  this  Convention  is  a  move  in  the  light  direc¬ 
tion,  and  I  wish  I  could  say  to  you  to-day  that  I  believe  our 


8 


MINUTES  OF  THE 


friends  in  the  capitol  will  give  an  appropriation  for  the  pur¬ 
pose  of  making  tnis  organization  permanent,  but  I  fear  you 
will  not  be  able  teget  it  at  this  Assembly.  I  know,  however, 
that  I  am  addressing  men  who  never  give  up  while  there  is 
life,  and  therefore  I  am  satisfied  you  will  keep  up  your 
organization  for  at  least  two  years,  when  it  will  be  the  duty 
of  the  Assembly  to  assist  this  organization  in  the  great  work 
it  has  undertaken  to  perform. 

I  wish  I  could  stay  with  you  this  morning,  but  I  only 
promised  the  Mayor  1  would  stay  here  a  minute.  I  am  now 
due  at  my  office.  Whenever  this  Convention  adjourns  it 
would  give  me  great  satisfaction  if  each  and  every  member 
of  it  will  come  to  the  Executive  office  and  allow  me  there 
to  extend  to  you  the  courtesies  of  North  Carolina  as  her 
chief  executive  officer. 

The  Chairman:  The  object  of  this  Convention  will  now 
be  explained  by  Dr.  R.  H.  Lewis,  of  Raleigh. 

Dr.  R.  H.  Lewis  :  I  am  very  sorry  indeed  to  have  to  make 
an  apology  to  this  assemblage,  but  unfortunately,  for  the  last 
week  or  two  my  time  has  been  so  occupied  that  it  has  been 
impossible  for  me  to  prepare  an  address  explanatory  of  the 
objects  of  this  meeting.  I  will,  however,  try  to  do  the  best 
I  can  in  setting  forth  the  object  with  which  we  are  assem¬ 
bled.  I  expected  to  address  a  mixed  audience,  composed  of 
the  laity  as  well  as  of  the  profession,  and  I  regret  to  see  that 
the  former  is  not  more  fully  represented.  It  is  well  known 
that  the  medical  profession,  who  have  to  deal  with  disease, 
have  been  the  pioneers  in  this  movement,  which  is  one  of 
the  children  of  this  Nineteenth  century,  and  the  principal 
promoters  of  it,  and  therefore  take  the  most  interest  in  it.  Sani¬ 
tary  science  has  advanced  more  rapidly  since  the  germ  theory 
has  been  more  generally  accepted  as  the  cause  of  disease.  We 
cannot  yet  lay  violent  hands  upon  these  enemies  of  the  human 
system  and  throttle  them.  It  is  true  we  know  comparatively 
little  about  germs,  but  we  know  something.  We  know,  for 


SA  X  IT  A  R  V  CO  X  VENTION. 


9 


instance  that  they  love  to  dwell  in  certain  localities — that  is 
to  say,  in  filth,  and  that  having  developed  there,  they  make 
inroads  upon  the  system  and  produce  disease.  It  is  the  duty 
of  the  sanitarian,  having  discovered  the  conditions  under 
which  they  live,  to  lay  waste  their  country  with  fire  and 
flood,  and,  if  possible,  wipe  them  off  the  face  of  the  earth. 
And  the  question  for  us  to  discuss  is  the  best  methods  of 
getting  rid  of  the  accumulations  of  filth.  We  know  that  one 
of  the  favorite  avenues  of  approach  to  the  human  system  is 
through  drinking  water,  as  is  particularly  shown  in  typhoid 
fever.  As  an  instance  of  this,  we  have  the  outbreak  in  Ply¬ 
mouth,  Penn.,  where  the  germs  were  thrown  out  upon  the 
snow.  Soon  after  a  thaw  occurred,  the  snow  melted  and 
was  washed  down  a  mountain  stream  into  the  reservoirs,  and 
just  at  the  end  of  the  computed  period  of  typoid  fever,  which 
is  14  days,  the  first  case  appeared,  and  that  first  case  was 
just  below  the  dam  into  which  the  melted  snow  was  washed. 
This  disease  continued  to  spread,  and  in  a  short  time,  com¬ 
paratively  speaking,  there  were  from  800  to  1,000  cases  in 
that  town  of  10,000  people.  A  striking  thing  about  it  was,  that 
the  people  who  had  typhoid  fever  were  the  people  who  drank 
water  from  this  mountain  stream,  which,  according  to  the 
chemist,  was  quite  pure;  whereas,  the  people  who  drank 
from  the  wells,  which  were  simply  abominable,  were  entirely 
free  from  this  disease.  It  is,  therefore,  clear  that  the  ques¬ 
tion  of  pure  drinking  water  is  a  matter  of  the  very  first 
importance.  No  doubt  other  diseases  enter  the  system 
through  the  drinking  water.  We  know,  too,  that  these  ene¬ 
mies  of  our  system  are  not  all  native  born,  but  some  of  them 
are  foreign ;  they  are  savages,  so  to  speak,  that  come  upon 
our  shores  from  across  the  sea — cholera,  yellow  fever,  and, 
possiblv,  diphtheria — and  we  want  to  devise  the  best  means 
of  keeping  them  out.  That  being  the  case,  it  is  of  the  first 
importance  we  should  consider  the  best  means  of  establish¬ 
ing  an  effective  quarantine.  I  do  believe  that  the  most 
important  work  for  the  sanitarian  lies  in  the  direction  of  iso- 


10 


MINUTES  OF  THE 


lation,  the  besieging, so  to  speak,  of  these  colonies  of  microbes,, 
and  preventing  their  spreading.  It  is  more  important  for 
sanitation  to  take  that  direction  than  it  is  to  dwell  upon  the 
removal  of  tilth,  though  both  are  important.  We  should  do 
everything  we  can  to  establish  legislation  for  that  purpose. 
Another  thing  which  is  the  very  foundation  of  all  sanitation, 
is  that  of  vital  statistics.  We  wish  to  devise  some  practica¬ 
ble  system  in  order  to  obtain,  as  far  as  possible,  these  data  for 
the  purpose  of  drawing  deductions  and  making  laws.  The 
progress  of  science  is  the  result  of  the  inductive  system  of 
reasoning,  and  it  is  necessary  to  accumulate  vast  numbers  of 
facts,  and  from  them  deduce  general  laws,  and  finally  organ¬ 
ize  a  body  for  the  purpose  of  carrying  out  these  laws.  I 
would  like  to  say  a  word  for  the  Board  of  Health  organized 
for  the  purpose  of  carrying  out  this  legislation.  We  would 
like  to  do  everything  we  can  to  bring  about  and  foster  a 
public  opinion  that  will  support  the  efforts  of  the  sanitarians. 
While  the  doctors  are  the  pioneers  and  promoters  of  these 
laws,  it  is  absolutely  impossible  for  them  ever  to  amount  to 
much  unless  they  are  supported  by  the  public.  The  public 
are  too  often  distrustful  of  the  object  of  the  doctors,  and 
cannot  understand  why  they  should  try  to  stamp  out  disease, 
and  thus  destroy  their  means  of  living;  but  they  are  not 
animated  by  selfish  motives— they  have  in  view  only  the 
good  of  the  people.  It  is  very  often  the  case  that  those  to 
whom  we  try  to  do  good  do  not  appreciate  our  efforts,  and 
are  cold  and  uninterested.  We  want  to  stir  up  interest 
among  the  people.  I  feel  very  much  gratified,  as  a  resident 
of  the  city  and  as  a  member  of  the  Board  of  Health,  to  see 
such  a  goodly  attendance,  and  I  only  regret  that  the  lay 
element  is  not  better  represented. 

Dr.  Tiros.  F.  Wood  moved  that  Hon.  A.  A.  Thompson, 
Mayor  of  Raleigh,  be  the  permanent  Chairman,  and  Hon. 
•J.  J.  Fowler,  Mayor  of  Wilmington,  be  the  Adce-President  of 
this  Association,  and  J.  C.  Chase,  C.  E.,  of  Wilmington,  and 
Dr.  Julian  M.  Baker,  of  Tarboro,  Secretaries.  Carried. 


SANITARY  CONVENTION. 


11 


Hon.  W.  E.  Fountain,  of  Tarboro,  and  Hon.  E.  B.  Neave, 
of  Salisbury,  were  also  made,  respectively,  second  and  third 
Vice-Presidents. 

Dr.  Wood  moved  that  each  person  present  come  forward 
and  register  their  names  in  order  to  determine  the  status  of 
the  Convention,  and  in  order  that  the  President  might  make 
the  committees,  which  had  to  be  formed  directly.  He  hoped 
that  each  member  present,  whether  layman  or  otherwise, 
would  register,  and  thus  encourage  those  who  had  taken  the 
initiative. 


COMMITTEE  ON  WAYS  AND  MEANS. 

The  Chairman  said  the  first  business  was  the  appointment 
of  a  Committee  of  Ways  and  Means,  and  the  meeting  must 
decide  how  many  that  committee  should  consist  of. 

Dr.  Wood  moved  that  the  Committee  of  Ways  and  Means 
consist  of  three  members,  which  was  carried. 

Committee  on  Ways  and  Mtaris. 

Dr.  Jno.  McDonald,  Washington,  N.  C.,  proposed  by  Dr 
R.  H,  Lewis. 

Oscar  Pearsall,  Wilmington,  proposed  by  Dr.  Wood. 

Dr  T.  F.  Wood,  Wilmington,  proposed  by  Mayor  Fowler. 

,  The  next  business  was  the  appointment  of  a  Committee 
on  Permanent  Organization.  Chairman  asked  of  how  many 
should  it  consist, 

Mr.  J.  C.  Chase  moved  that  the  Committee  on  Permanent 
Organization  consist  of  five  members,  which  was  carried. 

CommitUe  on  Permanent  Organization. 

Dr.  Eugene  Grissom,  proposed  by  Dr.  J.  M.  Hays. 

Dr.  W.  P.  Beall,  Greensboro  proposed  by  Dr.  R.  H.  Lewis. 
Mr.  J.  L.  Ludlow,  proposed  by  Dr.  T.  F.  Wood. 


12 


MINUTES  OF  THE 


Dr.  T.  F.  Wood,  proposed  by  Dr.  H.  T.  Bahnson. 

Dr.  R.  H.  Lewis,  proposed  by  Dr.  W.  T.  Ennett. 

Dr.  Wood  moved  that  the  Committee  on  Permanent 
Organization  be  allowed  until  the  evening  meeting  to  consult 
and  report.  Carried. 

Dr.  Wood  moved  that  Dr.  .J.  W.  Jones,  President  of  the 
North  Carolina  Board  of  Health,  read  his  paper  on  the 
“  Gains  of  Sanitation Carried. 

Dr.  J.  W:  Jones  then  proceeded  to  read.  (For.  Dr.  Jones’ 
paper  see  second  part  of  this  volume.) 

Dr.  Grissom:  It  seems  to. me  that  the  very  philosophical 
paper  just  read  by  Dr.  Jones  contains  not  only  information 
of  vast  value  to  the  public,  but  suggestions  still  more 
valuable.  If  there  is  any  regulation  existing  or  contem¬ 
plated  by  which  these  papers  are  to  be  published,  I  move  its 
publication. 

Dr.  Bahnson  suggested  that  the  paper  of  Dr.  Jones  be 
incorporated  in  the  report  of  the  State  Board  of  Health. 

Dr.  Wood:  \  would  like  to  say  that  the  insertion  of  that 
report  will  depend  very  much  upon  what  they  say  at  the 
capitol.  At  the  same  time  it  is  very  likely  there  will  be  no 
•objection  to  it,  and  if  not,  it  will  appear  in  the  Biennial 
Report  now  in  press.  That  course,  though,  will  not  prevent 
the  paper  assuming  a  more  popular  form,  and  as  a  member 
of  the  Committee  on  Ways  and  Means  I  would  say  that  if 
all  the  papers  are  like  that  of  Dr.  Jones,  we  should  have 
them  printed  as  coming  from  this  Convention  and  give  them 
as  wide  a  circulation  as  we  can  afford  to  give  them.  I  hope 
that  paper  will  not  be  lost  in  the  report  of  the  North  Caro¬ 
lina  Board  of  Health,  but  will  have  a  more  popular  distri¬ 
bution  than  a  volume  of  that  kind  is  likely  to  give  it. 

Dr.  Tucker  :  I  move  the  reference  of  this  paper  to  the 
Committee  on  Ways  and  Means.  Carried. 

Dr.  R.  H.  Lewis,  on  behalf  of  Dr.  Grissom,  invited  the 
members  of  the  Convention  to  visit  the  Insane  Asylum 


SANITARY  CONVENTION. 


IS 

either  as  a  body  or  individually,  where  they  would  receive  a 
most  hearty  welcome. 

Dr.  W.  G.  Curtis,  of  Southport,  then  read  a  paper  on 
“  Quarantine  ”  “  It  is  due  to  myself  to  say,  before  beginning 

to  read  my  paper,  that  it  was  written  in  the  expectation  that 
this  Convention  would  be  composed  of  a  large  number  of  per¬ 
sons  from  all  parts  of  the  State,  not  only  physicians,  but 
others,  and  that  we  should  have  a  good  many  of  our  legis¬ 
lators  present.”  (Dr.  Curtis’  paper  will  appear  in  the  second 
part  of  this  volume.) 

Dr.  Jno.  McDonald:  It  will  be  a  great  misfortune  if  a 
paper  like  this  and  the  one  preceding  it  should  fail  to  reach 
the  public.  I  move  it  be  referred  to  the  Committee  on 
Ways  and  Means,  with  instructions  to  give  it  as  wide  publi¬ 
cation  as  the  means  at  their  disposal  will  permit.  Seconded 
and  carried. 

Dr.  Wood  :  The  paper  which  has  just  been  read  is  one  of 
great  value,  and  does  not  apply  to  the  Cape  Fear  section  only,, 
although  that  is  a  large  part  of  the  State,  but  will  interest  every 
city  connected  with  Wilmington  by  railroad.  I  do  not  think 
many  of  the  gentlemen  present  realize  how  great  our  diffi¬ 
culties  are  at  Wilmington.  The  practical  workings  of  the 
law  Dr  Curtis  is  modest  enough  not  to  say  anything  about, 
because  he  has  performed  these  duties  so  faithfully  for  many 
years.  But  I  would  say  that  the  Quarantine  Station  is 
located  near  Southport,  at  deep  water  point,  Dr.  Curtis  being 
resident  at  Southport  as  inspector  of  vessels  coming  into  our 
port.  At  his  suggestion,  some  years  ago,  the  State  of  North 
Carolina  was  asked  to  add  to  the  Quarantine  Board  two 
gentlemen  from  the  city  of  Wilmington,  in  order  that  the 
citizens  of  Wilmington  might  be  better  satisfied  that  each 
vessel  was  properly  prepared  to  enter  the  river.  Now,  in 
managing  quarantine  we  have  not  only  to  provide  against 
disease,  but  also  against  panic,  which  the  fear  of  disease 
causes,  and  I  believe  the  greatest  difficulty  of  all  is  to  pro¬ 
vide  against  panic,  which  is  more  expensive  than  diseases 


14 


MINUTES  OF  THE 


are.  This  amendment  having  been  made  to  the  law  at  the 
suggestion  of  Dr.  Curtis,  the  practical  working  is  just  this, 
that  when  a  vessel  is  of  such  a  dangerous  nature  as  to 
require  more  particular  looking  after,  he  telegraphs  to  the 
city  of  Wilmington  and  informs  the  members  of  the  Quar¬ 
antine  Board,  who  pay  a  visit  to  the  station  and  inspect  the 
vessel  on  its  merits.  If  the  vessel  is  not  in  a  condition  to 
be  passed  at  once,  the  ballast  is  discharged,  the  vessel  as 
thoroughly  fumigated  as  means  will  permit,  and  is  either 
allowed  to  proceed  to  Wilmington,  where  she  takes  in  her 
cargo,  or  else,  if  she  is  very  dangerous,  in  the  judgment  of 
the  Board,  and  the  cleansing  has  not  been  sufficient,  not 
only  to  relieve  her  of  infection,  but  to  quiet  the  feelings  of 
the  citizens,  the  vessel  is  required  to  load  at  the  station, 
which  is  twenty-five  miles  down  the  river.  This  causes  an 
expense  which  is  very  burdensome,  and  it  is  highly  likely 
that  such  a  burden  would  diminish  the  trade  of  the  port. 
As  it  now  stands  the  two  gentlemen  who  are  the  represen¬ 
tatives  of  Wilmington,  are  almost  forbidden  from  taking 
their  summer  vacation  because  they  have  to  stand  between 
these  infected  vessels  and  the  community,  and  are  looked  to 
to  protect  the  people  against  these  infections,  and  it  is  a 
matter  of  great  urgency  and  absolute  necessity  that  we 
should  have  the  proper  means  of  disinfection  at  the  mouth 
of  the  river.  All  that  was  considered  necessary  heretofore 
was  to  take  a  pan  and  burn  sulphur  enough  to  fill  the  hold, 
&c.,  with  the  gas,  and  batten  down  the  hatch  until  the  gas 
had  reached  every  nook,  but  that  is  not  now  considered  suffi¬ 
cient,  and  will  not  satisfy  people  who  read  the  newspapers. 
They  say  “that  is  all  very  good,  but  it  is  ancient;  New 
Orleans  has  a  plan  far  ahead  of  that.”  Either  North  Caro¬ 
lina  must  build  this  quarantine  station  and  relieve  the  peo¬ 
ple  of  Wilmington  and  those  people  in  the  tributary  coun¬ 
try  from  this  anxiety  every  year,  and  the  damage  to  her 
commerce,  or  else  the  local  authorities  will  be  obliged  to 
build  it,  which  does  not  seem  fair.  I  particularly  desire  that 


s  A N I T A RY  (  ON  V  K X Tl(  >  N . 


15 


it  come  as  the  voice  of  this  Convention,  so  as  to  have  its 
proper  influence  on  the  Legislature,  that  the  quarantine  at 
Wilmington  be  properly  equipped.  I  wish  to  make  the  fol¬ 
lowing  motion  now  : 

Resolved,  That  “it  is  the  opinion  of  the  Convention  here  assembled, 
after  listening  to  Dr.  Curtis’  paper,  that  there  ought  to  be  a  proper 
quarantine  established  at  the  mouth  of  the  Cape  Fear  River  at  South- 
port,  and  that  the  General  Assembly  be  asked  to  make  the  appropria¬ 
tion  which  is  set  forth  in  the  bill  now  pending.” 

Dr.  R.  H.  Lewis:  I  think  that  if  the  members  of  this 
Convention,  particularly  those  from  other  sections  than  the 
Cape  Fear  section,  would  see  the  members  of  their  counties 
and  other  members  they  know  and  impress  upon  them  the 
fact  that  this  quarantine  is  not  needed  for  the  city  of  Wil¬ 
mington  alone,  but  for  the  protection  of  the  whole  State,  and 
that  it  is  their  duty  to  vote  for  this  apparently  local  measure 
for  the  purpose  of  protecting  the  whole  community,  and 
that  it  is  essential  for  the  protection  of  the  people  living 
inland,  that  it  would  have  a  very  good  effect.  1  beg  to  sec¬ 
ond  Dr.  Wood’s  motion. 

Dr.  Wood:  I  would  like  to  state  that  the  quarantine  sta¬ 
tion  belongs  to  the  State  of  North  Carolina.  One  of  the 
oldest  laws  on  our  statute  book  is  the  law  creating  a  quaran¬ 
tine  at  Fort  Johnston.  It  is  the  ancient  property  of  the 
State,  and  for  that  reason  it  seems  to  me  that  it  is  the  imper¬ 
ative  duty  of  the  State  to  see  that  it  is  perfected  and  brought 
to  the  highest  state  of  efficiency.  The  State  has  land  down 
there  and  every  facility,  and  all  that  is  needed  is  money.  I 
hope  every  member  of  this  Convention  will  see  all  the 
members  of  the  Assembly  that  he  knows  and  point  out  that 
the  property  does  not  belong  to  the  city  ol  \V  ilmington,  but 

to  the  whole  of  North  Carolina. 

Dr.  Bahnson  read  a  paper  prepared  by  Dr.  G.  G.  Ihomas 
(who  had  been  obliged  to  return  to  Wilmington),  on  “  Inland 


1(> 


MINUTED  OF  THE 


Quarantine.''  (Dr.  Thomas’  paper  will  be  found  in  the  second 
part  of  this  volume.) 

Dr.  W.  T.  Ennett  moved  that  the  excellent  paper  of  Dr. 
G.  G.  Thomas,  read  by  Dr.  Bahnson,  be  referred  to  the  Com¬ 
mittee  on  Ways  and  Means,  with  instructions  to  have  it  pub¬ 
lished  as  soon  as  possible.  Carried. 

Dr.  Wood  moved  that  the  Chair  appoint  a  committee  to 
select  delegates  to  the  number  of  ten  to  the  Convention  in 
Montgomery,  Ala.,  and  suggest  these  names  to  the  Governor, 
who  had  said  that  he  would  be  willing  to  appoint  such  gen¬ 
tlemen  as  were  selected  bv  this  Convention. 

Committee  to  select  delegates  to  the  Southern  Convention, 
Montgomery,  Ala.:  Dr.  T.  F.  Wood,  Dr.  J.  W.  Jones,  Dr.  H. 
T.  Bahnson. 

The  meeting  then  adjourned  until  8  o’clock  p.  m. 


EVENING  session. 

Mayor  J.  J.  Fowler,  Vice-President,  in  the  chair. 

Dr.  T.  F.  Wood  read  the  report  of  the  Committee  on  Per¬ 
manent  Organization.  He  explained  that  they  had  made  it 
as  brief  as  possible,  because  it  did  not  seem  desirable  to  have 
any  cumbersome  machinery,  and  they  would  start  out  with 
as  simple  a  one  as  possible,  and  leave  room  for  amendments 
as  occasion  may  demand. 

After  some  discussion  the  Constitution,  as  presented,  was 
adopted : 

NAME. 

Article  1.  This  Association  shall  be  known  as  the  North  Carolina 
Sanitary  Association. 

objects. 

Art.  2.  This  Association  shall  have  for  its  objects  the  inculcation  of 
the  principles  and  practice  of  public  and  private  hygienics  and  the  inves¬ 
tigation  of  all  subjects  appertaining  to  the  public  health. 


SANITARY  CONVENTION. 


17 


MEMBERSHIP. 

Art.  3.  Any  person  may  become  a  member  of  this  Association  who 
is  interested  in  the  study  and  promotion  of  hygiene,  provided  he  is 
endorsed  by  a  member  of  the  Association  in  writing  and  receives  a 
majority  of  the  votes. 

OFFICERS. 

Art.  4.  The  officers  shall  be  President,  Vice-President,  Recording  and 
Corresponding  Secretary,  and  a  Treasurer. 

MEETINGS. 

Art.  5.  The  meetings  shall  be  annual,  the  time  and  place  settled  by 
the  Executive  Committee. 

EXECUTIVE  COMMITTEE. 

Art.  6.  There  shall  be  an  Executive  Committee  of  five  appointed 
by  the  President,  whose  duty  it  shall  be  to  prepare  all  business  in 
advance  of  the  meeting  of  the  Association,  and  shall  also  determine 
what  papers  shall  be  presented,  and  shall  prepare  the  programme  and 
settle  the  place  and  time  of  meeting. 

COMMITTEE  ON  WAYS  AND  MEANS. 

Art.  7.  There  shall  be  a  Committee  of  three  on  Ways  and  Means,  who 
shall  prepare  for  the  expenses  attending  the  Association,  audit  all  bills 
before  being  paid  by  the  Treasurer,  and  have  charge  of  the  publication 
of  the  proceedings  of  the  Association. 

DUES. 

Art.  8.  There  shall  be  an  annual  assessment  of  $...  for  the  support  of 
the  Association,  the  amount  to  be  determined  by  the  suggestion  of  the 
Committee  on  Ways  and  Means,  and  approved  by  a  majority  vote. 

Dr.  O’Hagan  said  that  the  Committee  on  Ways  and 
Means  were  directed  to  defray  the  expenses  of  publication, 
but  no  means  were  provided  whereby  these  expenses  should 

be  met. 

2 


18 


MINUTKS  OF  THE 


Dr.  Wood  said  the  committee  would  be  glad  to  receive 
any  suggestions  from  Dr.  O’Hagan.  The  intention  was 
that  the  committee  would  suggest  an  assessment  at  each 
meeting. 

Dr.  Grissom  moved  that  the  blank  be  filled  by  the  inser¬ 
tion  of  an  assessment  of  two  dollars. 

Dr.  O’Hagan  moved  that  it  be  five  dollars. 

Dr.  Wood  desired  to  have  it  left  to  the  committee  to 
decide. 

Dr.  Grissom’s  motion  was  carried. 

The  Committee  on  Permanent  Organization  recommended 
that  the  present  officers  of  the  Convention  be  made  the  per¬ 
manent  officers  of  the  Association,  which  was  carried. 

The  Chairman  called  attention  to  the  fact  that  the  con¬ 
stitution  provided  for  the  election  of  a  Treasurer.  A  dis¬ 
cussion  followed  as  to  the  advisability  of  combining  the 
offices  of  Secretary  and  Treasurer,  but  the  Chairman  pointed 
out  that  the  constitution  clearly  provided  for  two  secretaries 
and  a  treasurer. 

Dr.  Bahnson  then  moved  that  Dr.  Grissom  be  elected 
Treasurer,  which  was  seconded  and  carried. 

Dr.  Grissom  said  there  could  not  be  a  better  time  than 
the  present  for  receiving  the  assessment  of  two  dollars  per 
member,  and  he  would  be  glad  to  receive  the  amount  at  once 

The  members  present  responded  by  paying  at  once. 

Dr.  Bahnson  moved  that  the  Chairman  be  allowed  until 
to-morrow  to  nominate  an  Executive  Committee  of  five. 
Carried. 

Dr.  Bahnson  then  read  a  paper  on  “  The  Water  Supplies  oj 
Towns  and  Cities  in  North  Carolina .”  (Dr.  Bahnson’s  paper 
will  appear  in  the  second  part  of  this  volume.) 

Dr.  R.  H.  Lewis  said :  I  have  listened,  and  1  am  sure  all 
of  us  have  listened  to  Dr.  Bahnson’s  admirable  paper,  with 
very  great  pleasure.  The  question  of  pure  water  is  one  of 
the  first  importance,  and  in  moving  the  reference  of  this 
paper  to  the  Committee  on  Ways  and  Means  for  publication. 


SANITARY  CONVENTION. 


19 


I  would  like  to  add  that  they  be  instructed,  if  the  funds  in 
hand  will  justify  it,  even  if  they  cannot  publish  all  the  papers 
of  this  Convention,  that  this  particular  paper  be  published 
in  pamphlet  form  for  distribution  among  the  towns  of  our 
State.  Dr.  Bahnson  has  exhausted  the  subject  and  put  it 
in  a  simple  and  eloquent  form,  and  I  am  sure  nothing  would 
do  more  to  instruct  the  people  of  our  State  on  this  impor¬ 
tant  question.  Should  the  funds  in  hand  not  be  sufficient, 
I  will  cheerfully  subscribe  to  have  this  done. 

Mr.  Oscar  Pearsall  :  I  rise  to  second  that  motion,  because 
I  am  in  hearty  sympathy  with  it,  and  I  would  like  to  have 
some  of  these  pamphlets  for  distribution  in  Wilmington. 

Prof  F.  P.  Venable,  of  the  University  of  North  Carolina, 
said :  I  would  like  to  call  the  attention  of  the  Association  to  a 
method  of  purifying  water  which  has  lately  been  mentioned 
authentically  in  the  papers,  and  which,  I  think,  is  well  worthy 
of  the  attention  of  the  Association.  It  is  a  method  that  has 
been  put  in  operation  in  the  towns  in  the  Netherlands,  and 
wonderful  results  are  claimed  for  it.  It  is  called  the  “  Anderson 
Iron  Process,”  and  is  dependent  upon  the  purifying  action  of 
bright  pieces  of  iron.  The  water  is  forced  through  a  pipe 
into  a  long  boiler  of  iron,  where  it  comes  against  a  disc,  so 
that  it  is  forced  into  a  broader  stream  and  much  more  sur¬ 
face  is  exposed.  Inside  the  boiler  are  a  number  of  shelves, 
on  which  are  placed  numbers  of  little  pellets  of  iron.  The 
boiler  is  kept  revolving  all  the  time,  and  as  it  revolves  these 
iron  pellets  are  lifted  and  made  to  fall  through  the  stream 
of  water.  The  continual  friction  of  the  pellets  keeps  them 
bright.  At  the  opposite  end  of  the  boiler  is  a  cone,  which 
gathers  the  water  again  and  carries  it  off  The  water,  alter 
leaving  the  boiler,  is  serated  by  passing  over  coke,  and  is 
then  allowed  to  filter  through  sand.  It  comes  out  perfectly 
clear  and  bright,  and  will  stand  the  test  of  being  kept  sev¬ 
eral  years  without  changing.  This  is  a  very  severe  test,  and 
as  a  rule,  only  distilled  water  will  stand  it  successfully .  1  he 
cost  of  this  process  is  $3.35  per  100,000  gallons,  and  the 


20 


MINUTES  OF  THE 


original  plant  will  cost  only  $5,000  for  a  capacity  of 
1,000,000  daily.  There  are  works  at  Ostend  and  Antwerp 
and  two  or  three  other  places  in  the  Netherlands,  and  the  pro¬ 
cess  has  been  applied  to  the  waters  of  the  Seine.  The  pro¬ 
cess  was  unsatisfactory  at  Berlin,  and  the  failure  is  said  to 
be  due  to  the  large  amount  of  iron  salts  in  the  water,  though 
that  reason  was  given  without  proper  investigation. 

Mr.  J.  C.  Chase,  of  Wilmington,  continuing  the  discus¬ 
sion,  said  he  agreed  with  Dr.  Bahnson  that  in  a  question  of 
such  vital  importance  as  the  supply  of  pure  water  the  cost 
ought  to  be  a  secondary  consideration.  With  regard  to  the 
process  described  by  Prof.  Venable,  the  superintendent  of  the 
water  works  at  New  Orleans  had  a  process  with  iron  which 
worked  admirably  with  the  water  of  the  Mississippi ;  but  the 
least  quantity  which  could  be  used  at  Wilmington  left  such 
a  taste  in  the  water  that  it  was  immediately  discarded. 
Another  difficulty  they  had  to  contend  with  in  Wilmington 
was  the  tidal  influence,  and  nearly  every  year  they  had  an 
irruption  of  brackish  water,  which  of  course  no  filter  could 
handle. 

Prof.  Venable  read  a  paper  on  “  The  Intervention  of  the 
Slate  in  the  matter  of  the  Adulteration  of  Food."  (Prof.  Vena¬ 
ble’s  paper  will  be  found  in  the  second  part  of  this  volume.) 

Dr.  Wood  :  There  is  a  law  of  North  Carolina  providing 
for  the  examination  of  adulterated  food,  and  the  employ¬ 
ment  of  the  provisions  of  the  law  is  optional  with  the  citi¬ 
zens.  Any  one  having  an  article  of  suspected  food  can  have 
it  examined  at  the  expense  of  the  State  by  sending  it  through 
the  State  Board  of  Health  to  the  Agricultural  Experiment 
Station.  There  has,  however,  been  only  one  application  for 
examination  in  eight  years,  and  this  application  came  from 
a  whiskey  distiller  who  wanted  to  know  if  the  State  Board 
of  Health  would  permit  the  examination  of  whiskey,  as  he 
claimed  he  had  the  purest  whiskey  in  North  Carolina,  The 
Board  replied  that  they  did  not  consider  whiskey  a  food.  It 
is  only  by  such  methods  as  Prof.  Venable  explains  that  we 


SANITARY  CONVENTION. 


21 


can  awaken  the  people  from  their  lethargy,  for  the  people 
do  not  know  the  extent  of  these  adulterations,  and  no  inter¬ 
est  is  excited.  In  the  report  of  the  North  Carolina  Board  of 
Health,  which  is  now  in  press,  we  have  only  a  short  table  of 
analyses  which  were  kindly  made  voluntarily  by  Prof. 
Venable,  of  drugs  selected  from  different  druggists  without 
their  knowledge  that  they  were  to  be  analyzed.  The  num¬ 
ber  of  analyses  made  are  few,  but  they  are  leaders  showing 
exactly  the  direction  that  this  matter  is  going  to  take.  The 
articles  selected  were  bismuth,  quinine,  laudanum  (U.  S.  Ph.,) 
and  grocer’s  laudanum.  There  were  several  specimens  of 
these  articles  and  hardly  any  were  pure.  These  analyses 
showed  that  some  of  the  oldest  chemists  in  this  country  sell 
bismuth  with  a  trace  of  lead  in  it,  and  other  impurities,  and 
whilst  they  are  not  harmful,  they  are  certainly  not  what  they 
pretend  to  be.  It  is  just  this  instruction  which  the  people 
of  North  Carolina  need.  They  need  to  have  these  sermons 
put  under  their  noses  in  printer’s  ink  in  simple,  short  arti¬ 
cles  which  they  can  understand ;  for  it  is  shown  that  even 
people  who  are  trying  their  best  to  give  us  pure  food  and 
pure  medicines  are  selling  impure  ones  and  are  entirely 
unaware  of  the  fact.  I  think  it  highly  desirable  that  papers 
like  Prof.  Venable’s  should  be  sent  broadcast  over  the  land, 
and  I  hope  the  Committee  on  Ways  and  Means  will  get 
enough  money  to  print  all  these  papers. 

,  Mr.  Oscar  Pearsall,  of  Wilmington :  I  want  to  call  the 
attention  of  this  Association  to  a  matter  of  considerable 
importance,  and  one  which  the  Association  has  already 
pledged  its  support  and  influence  to.  I  allude  to  the  rebuild¬ 
ing  of  the  Quarantine  Station  at  Deep  Water  Point  on  the 
Cape  Fear  River.  I  learn  to-day  that  a  bill  has  already 
been  introduced  in  the  Senate  providing  for  an  appropria¬ 
tion,  and  has  been  referred  to  the  Finance  Committee.  The 
chairman  of  this  committee  happens  to  be  an  acquaintance 
of  mine,  and  at  my  request  has  expressed  his  willingness  to 
receive  a  committee  from  this  Association  on  this  matter.  I 


22 


MINUTES  OF  THE 


move,  therefore,  that  a  committee  be  appointed  to  wait  upon 
the  Finance  Committee  of  the  Senate  to  urge  the  importance 
of  this  matter,  and  1  would  suggest  that  Dr.  Wood  be  one  of 
the  committee,  as,  being  a  member  of  the  Quarantine  Board, 
he  can  give  the  Senate  all  the  information  they  require. 

Dr.  Roberts  seconded  the  motion. 

Committee  appointed  to  wait  on  Finance  Committee  of  the 
Senate:  Dr.  Wood,  Dr.  O’Hagan,  Dr.  Hubert  Haywood, 
Hon.  J.  J.  Fowler,  Mr.  Oscar  Pearsall. 

Mr.  J.  C.  Chase  :  The  Governor  of  the  State  very  cordially 
invited  the  Convention  to  call  upon  him  either  individually 
or  in  a  body,  and  I  think  it  is  only  proper,  considering  his 
courtesy  in  welcoming  us  here,  that  we  should  make  a  call.  I 
would  suggest  that  the  members  meet  here  at  10  o’clock  and 
call  at  once  upon  the  Governor  in  a  body.  This  was 
agreed  to. 

The  meeting  then  adjourned  till  10:30  o’clock  the  follow¬ 
ing  morning. 


SECOND  DAY. 

7th  February,  1889. 

Hon.  A.  A.  Thompson,  President,  in  the  chair. 

The  meeting  was  opened  at  10:30,  with  prayer  by  the  Rev. 
Mr.  Cordon. 

Dr.  Hanks  and  Dr.  Knox  were  appointed  a  committee  to 
inform  Gov.  Fowle  that  the  Convention  proposed  to  call  upon 
him  in  a  body  at  1:45,  if  it  was  his  pleasure. 

Mr.  J.  L.  Ludlow,  C.  E.,  read  a  paper  on  “  The  Disposal  of 
the  Refuse  of  Towns."  (Mr.  Ludlow’s  paper  will  be  found  in 
the  second  part  of  this  volume.) 

Dr.  Bahnson:  I  rise  to  express  the  thanks  of  this  Conven¬ 
tion  to  Mr.  Ludlow  for  the  paper  he  has  favored  us  with, 
and  to  move  that  it  be  referred  to  the  Committee  on  Wavs 

V 

and  Means  for  publication.  Carried. 


SANITARY  CONVENTION. 


/ 


23 


Dr.  Grissom  :  It  is  well  known  that  the  theory  prevailed 
for  a  long  time  but  to  what  extent  it  is  now  prevalent  1 
am  not  prepared  to  say  that  the  excessive  use  of  sewage  as 
a  fertilizer,  and  especially  upon  edible  crops,  produces  an 
unhealthy  element  in  these  crops,  and,  if  I  understand  Mr. 
Ludlow,  he  recognizes  that  effect.  I  would  like  to  inquire 
of  him  to  what  extent  that  theory  now  prevails,  whether  it 
was  a  mere  theory,  and  whether  it  has  been  overturned  by 
further  experience? 

Mr.  Ludlow:  The  theory  did  find  a  good  deal  of  favor, 
but  it  is  now  established  that  with  the  exception  of  the  excre¬ 
ment  of  persons  suffering  from  a  disease  which  is  infectious 
by  the  excrement — as,  for  instance,  typhoid  fever — there  is 
no  danger  either  to  cattle  eating  grass  or  to  people  eating 
garden  produce  fertilized  by  sewage.  There  is  a  garden  near 
Paris  fertilized  entirely  by  sewage,  and  it  is  famed  as  pro¬ 
ducing  the  finest  strawberry  crops  in  the  world.  The  theory 
is  not  borne  out,  excepting  in  the  case  where  the  excrement 
is  from  typhoid  patients,  and  the  only  way  of  eliminating 
this  danger  is  in  the  complete  disinfection  of  the  excrement 
by  the  physicians  attending  such  cases.  We  cannot  treat 
the  sewage  sufficiently  to  overcome  this  ;  it  should  be  the 
duty  of  the  physician. 

Dr.  Grissom  :  I  am  gratified  at  the  explanation  given  by 
Mr.  Ludlow,  and  it  seems  to  me  to  be  a  source  of  gratifica¬ 
tion  to  those  who  wish  to  make  the  system  practicable.  1 
have  myself,  in  the  very  limited  experience  1  have  had  dur¬ 
ing  twenty  years,  had  great  doubt  about  the  effect  ot  using 
sewage  as  a  fertilizer  broadcast.  I  know  good  effects  have 
followed  its  use,  but  I  attributed  it  to  the  fact  that  the  places 
where  it  was  used  required  considerable  irrigation,  and  1 
thought  the  beneficial  effects  were  due  not  so  much  to  the 
manurial  properties  of  the  sewage  as  to  the  irrigation.  Still, 
an  experience  so  limited  as  my  own  is  not  entitled  to  any 
great  respect,  and  I  am  glad  to  say  that  the  paper  will  be 


24 


MINUTES  OF  THE 


quite  an  inducement  to  study  the  subject  from  a  more  learned 
standpoint. 

Dr.  O’Hagan  :  I  have  listened  to  the  paper  of  Mr.  Ludlow 
with  a  great  deal  of  pleasure,  and,  I  think,  with  a  great  deal 
of  profit.  This  question  of  the  disposal  of  garbage  and  ani¬ 
mal  matter  has  become  a  great  public  question  which  is 
tasking  the  minds  of  the  wisest  and  best  men  in  the  world. 
We  have  not  reached  it  yet,  because  the  population  is  too 
sparse,  but  at  no  distant  day  the  question  will  confront  us, 
and  it  is  well  that  the  medical  men  and  the  laity  should  be 
educated  up  to  the  point  that  they  will  know  how  to  dispose 
of  it  in  the  most  efficient  manner.  Mr.  Ludlow’s  paper  is 
valuable  inasmuch  as  he  has  touched  upon  all  points — not 
only  the  sanitary,  but  the  financial  as  well ;  and  when  we 
have  to  appeal  to  the  laity  and  to  the  municipal  authorities, 
the  financial  question  transcends  all  others.  Our  govern¬ 
ing  bodies  need  to  be  educated  up  to  the  point  to  know  that 
whatever  tends  to  bring  about  good  health  is  cheap.  Mr. 
Ludlow’s  paper  is  of  very  great  value,  and  as  an  educational 
paper  it  ought  to  be  known  throughout  the  State,  and  I 
would  respectfully  suggest  that  as  many  copies  as  the  finances 
of  the  Committee  on  Ways  and  Means  will  permit  be  printed 
for  distribution. 

Dr.  Thomas  F.  Wood  read  a  paper  on  How  can  we  best 
secure  the  Economical  Disposal  of  Refuse  in  our  Towns ,  with 
some  Remarks  on  the  Garbage  Furnaces  in  use”  (Paper  will 
appear  in  second  part  of  this  volume.) 

I  woulk  like  to  remark  before  I  read  my  short  paper  that 
I  for  one  am  very  much  obliged  to  Mr.  Ludlow  for  the 
paper  he  has  just  read,  and  would  like  to  say  for  the  infor¬ 
mation  of  the  Convention  that  Mr.  Ludlow  is  the  Sanitary 
Engineer  for  the  State  Board  of  Health,  and  during  the 
last  year  he  has  devoted  much  of  his  time  to  the  study  of 
the  question.  One  of  his  papers  is  now  being  printed  by 
the  State  as  part  of  the  transactions  of  the  State  Board  of 
Health,  and  T  would  like  to  remark  that  if  any  gentlemen 


SANITARY  CON  V  ENT  ION. 


25 


desire  to  receive  this  paper  I  will  cheerfully  send  them  the 
volume  when  it  is  finished,  which  will  be  in  about  two 
months.  The  volume  will  not  only  contain  Mr.  Ludlow’s 
paper,  but  Dr.  Bahnson’s  and  others,  which  will  be  consid¬ 
ered  as  text-books  for  many  years  to  come.  The  North  Caro¬ 
lina  Board  of  Health  desires  to  keep  in  advance  of  the 
thinking  people  of  the  State,  and  these  papers  are  intended 
to  keep  the  subjects  before  them.  Knowing  what  Mr.  Lud¬ 
low’s  paper  would  be  I  have  taken  up  the  more  practical 
part  of  the  disposal  of  garbage. 

On  the  motion  of  Dr.  Grissom  the  paper  by  Dr.  Wood 
was  referred  to  the  Committee  on  Ways  and  Means. 

Dr.  Wood  then  introduced  Mr.  Morse,  representative  of 
the  Engle  Garbage  Furnace,  and  the  following  is  given  as  a 
synopsis  of  his  remarks  : 

Mr.  Morse,  on  being  introduced,  said  that  he  was  not  a 
sanitary  expert  and  had  no  arguments  to  advance  on  the 
subject.  He  wished  simply  to  bring  before  their  notice  the 
workings  of  the  furnace  built  by  the  Engle  Sanitary  and 
Crematory  Company,  which  he  claimed  destroyed  all  garb¬ 
age,  &c.,  detrimental  to  health,  and  was  the  simplest,  most 
effective  and  cheapest  manner  of  getting  rid  of  the  sewage 
and  garbage  of  a  town.  It  might  be  said  that  this  was  a 
broad  assertion  to  make,  but  he  could  give  evidence  to  show 
that  he  was  fully  justified  in  making  it.  Mr.  Morse  then 
described  at  some  length  the  furnaces  which  his  company 
had  erected  on  Staten  Island  and  at  Milwaukee,  &c.,  and  the 
severe  tests  which  they  had  undergone,  and  read  testimo¬ 
nials  from  the  health  officers  at  these  places  testifying  to  the 
complete  success  which  they  had  achieved.  Mr.  Morse 
stated  that  these  furnaces  did  not  require  any  expert  attend¬ 
ants,  and  would  completely  burn  up  all  sewage  and  garbage 
matter  (with  the  exception  of  ashes),  and  that  the  combus¬ 
tion  was  so  complete  that  there  was  absolutely  no  smoke 
or  offensive  smell  emitted.  The  residue  was  also  valuable 
as  a  fertilizer.  Other  methods  ol  utilizing  sewage  as  a  tertil- 


26 


MINUTES  OF  THE 


izer  were  costly  and  more  or  less  dangerous  to  health,  and, 
moreover,  it  had  been  demonstrated  that  such  fertilizer  did 
not  contain  more  than  four  per  cent,  of  fertilizing  proper¬ 
ties,  as  nearly  all  the  ammonia,  &c.,  was  lost  in  its  prepara¬ 
tion. 

Mr.  Morse  invited  health  officers  and  others  interested  in 
the  subject  to  communicate  with  him,  and  he  would  be 
pleased  to  give  estimates  and  all  particulars  for  the  erection 
of  these  furnaces. 

Dr.  J.  H.  Tucker  read  a  paper  on  “  The  Duties  and  Respon¬ 
sibilities  of  Superintendents  of  Health .”  (Dr.  Tucker’s  paper 
will  be  found  in  the  second  part  of  this  volume.) 

Dr.  Jno  McDonald,  in  moving  that  Dr.  J.  H.  Tucker’s 
paper  be  referred  to  the  Committee  on  Ways  and  Means, 
suggested  that  another  assessment  be  made,  as  there  were  not 
sufficient  funds  in  hand  to  publish  all  the  papers,  and  he 
did  not  wish  any  of  them  should  be  lost,  as  it  was  just  the 
kind  of  literature  needed. 

Dr.  O’Hagan  said  the  assessment  of  $2  was  too  small  to 
accomplish  anything,  and  he  wanted  to  see  it  increased. 

Mr.  Morse  said  he  wished,  on  behalf  of  the  Engle  Sani¬ 
tary  Furnace  Company,  to  contribute  $10  towards  the  fund 
for  the  publication  of  these  papers. 

A  resolution  was  offered  thanking  Mr.  Morse  for  his  gener¬ 
ous  donation,  which  was  unanimously  adopted. 

Mr.  J.  C.  Chase  thought  it  was  not  necessary  at  that  time 
to  increase  the  assessment.  The  secretaries  intended  to  at 
once  send  out  a  circular  letter  which  they  hoped  would  have 
the  effect  of  increasing  the  membership  considerably,  and 
he  thought  they  would  then  have  sufficient  funds  to  meet 
all  the  expenses  in  sight. 

Dr.  H.  T.  Bahnson  :  I  learn  since  last  night  that  there  is 
an  effort  being  made  on  the  part  of  several  municipalities — 
Charlotte  and  Greensboro,  &c. — to  have  a  special  law  passed 
to  protect  their  water  supplies,  and  it  strikes  me  that  this  is 
the  time  when,  if  possible,  an  effort  should  be  made  to  get 


SANITARY  CONVENTION. 


27 


general  legislation  on  the  subject.  I  have  spoken  with  the 
Superintendent  of  Health  of  Raleigh,  who  says  he  will  join 
in  an  effort  to  get  a  law  which  will  not  only  cover  water 
supplies  already  made,  but  such  as  may  be  made  in  the 
future.  I  will  ask  Colonel  Keogh,  who  is  here  in  the  inter¬ 
est  of  Greensboro,  to  favor  us  with  a  few  remarks. 

Col.  Thos.  B.  Keogh  :  There  is  not  much  that  I  can  say 
on  the  subject.  Dr.  Bahnson  has  already  presented  the 
question,  and  that  is  all  there  is  of  it.  I  am  here  to  secure, 
if  possible,  special  legislation  for  the  protection  of  our  water¬ 
shed,  and  to  prevent  pollution  of  the  supply  and  the  streams 
which  are  tributary  to  it.  It  appears  to  me  that  a  movement 
from  the  Sanitary  Convention  would  receive  more  attention 
from  the  legislators  than  anything  coming  from  a  private 
source,  and  I  think  it  would  be  much  better  if  you  would 
join  as  an  association  and  have  a  bill  framed  to  apply  to  the 
whole  State,  not  only  for  present  water  supplies,  but  for  all 
future  water  supplies.  It  is  a  question  which  affects  the 
whole  State,  and  I  think  we  should  be  much  more  likely  to 
succeed  if  this  Sanitary  Association  took  it  up. 

Dr.  H.  T.  Bahnson  moved  that  a  committee  consisting  of 
representatives  from  the  various  towns  interested  in  water 
works  be  appointed  by  this  Convention,  with  Col.  Keogh,  who 
is  one  of  our  members,  to  draft  a  bill  with  a  view  to  general 
legislation  on  this  subject  and  prohibiting  the  pollution  ot 
any  water  supplies. 

Prof.  J.  L.  Ludlow  thought  that  such  legislation  would 
prove  very  one-sided.  He  was  afraid  that  it  would  have 
the  effect  of  practically  confiscating  all  land  surrounding 
water  supplies,  as  the  owners  would  be  prohibited  from 
building  on  it. 

Dr.  T.  F.  Wood  seconded  the  motion  of  Dr.  Bahnson,  as  he 
believed  it  ought  to  come  forward  as  the  opinion  of  this 
Convention  that  legislation  to  protect  the  water  supplies  oi 
the  country  was  needed. 


28 


MINUTES  OF  THE  SANITARY  CONVENTION. 


Prof.  Venable  moved  the  amendment  that  a  standing 
committee  of  this  Convention  be  formed  to  undertake  such 
legislation  as  may  be  considered  necessary  from  time  to 
time.  Carried,  and  the  President  announced  the  Committee 
on  Legislation  with  reference  to  water  supplies  to  be  Dr. 
James  McKee,  Dr.  J.  H.  Tucker,  Prof.  F.  P.  Venable. 

The  Convention  then  adjourned  sine  die,  and  the  members 
went  in  a  body  to  call  on  Gov.  Fowle  at  his  office,  as  pre¬ 
viously  arranged. 


MEMBERS  OF  THE  NORTH  CAROLINA 
SANITARY  ASSOCIATION. 

- 9 - 

Pi.  D.  L.  Adams  ...  . Raleigh. 

H.  B.  Battle,  Ph.  D.,  State  Chemist .  u 

Dr.  K.  P.  Battle,  Jr .  « 

Julian  M.  Baker,  County  Sup’t  of  Health _ Tarboro. 

“  Henry  T.  Bahnson,  State  Board  of  Health . Salem. 

“  W.  P.  Beall . Greensboro. 

Col.  W .  F .  Beasley . . . . Oxford. 

Dr.  VV .  J.  H.  Bellamy . Wilmington, 

W.  H.  Bobbitt . ; . Raleigh. 

John  C.  Chase,  C.  E.,  Hydraulic  and  Sanitary  En¬ 
gineer  . Wilmington. 

Rev.  J.  H.  Clewell ....  . Salem. 

Dr.  W.  G.  Curtis,  Quarantine  Officer . Southport. 

Rev.  J.  F.  Crowell,  D.  D.,  President  Trinity  CollegeRaleigh. 

Dr.  B.  F.  Dixon . . Oxford. 

E.  B.  Engelhard,  Esq.,  Superintendent  Water  Co.  .Raleigh. 

Dr.  W.  T.  Ennett,  President  N.  C.  Medical  Society,  Wilmington. 

John  J.  Fowler,  Esq.,  Mayor . . .  “ 

W.  E.  Fountain,  Esq.,  “  . Tarboro. 

Dr.  F.  H.  Fries . . . . . . Salem. 

F.  T.  Fuller . Raleigh. 

“  Eugene  Grissom,  Sup' t  Insane  Asylum . Raleigh, 

“  L.  A.  Hanks,  County  Sup’t  of  Health .  .  . .  .Pittsboro. 

“  Dr.  F.  H.  Harris . Henderson. 

J.  M.  Hays . Oxford. 

“  E.  Burke  Haywood . Raleigh. 


Dr  Hubert  Haywood ... .  . .Raleigh. 

G.  W.  Hinshaw,  Esq . Winston. 

Dr.  P.  E.  Hines  . Raleigh 

“  J.  A.  Hodges . Fayetteville. 

u  J.  W.  Jones,  Pres’t  State  Board  of  Health. .  .  .Tarboro. 

T.  B.  Keogh,  Esq.  . . Greensboro. 

Dr.  A.  W.  Knox. ...  . Raleigh. 

u  R.  F.  Lewis,  County  Sup’ t  of  Health.  . .  • .  Lumberton. 

“  H.  W.  Lewis,  County  Sup’ t  of  Health . ..Jackson. 

R.  H.  Lewis,  State  Board  of  Health . Raleigh. 

'  J.  L.  Ludlow,  C.  E.,  Civil  and  Sanitary  Engineer.  .Winston. 

Dr.  J.  L.  Malone . Louisburg. 

“  John  McDonald,  State  Board  of  Health . Washington. 

Dr.  J.  W.  McGee . Raleigh. 

“  James  McKee,  County  Sup’t  of  Health .  “ 

“  W.  P.  Mercer . Toisnot. 

Rev.  L.  L.  Nash .  . Raleigh. 

E.  B.  Neave,  Esq.,  Mayor  . Salisbury 

Dr.  C.  J.  O’ Hagan . Greenville. 

Oscar  Pearsall,  Esq.,  Chm’n  City  Sanitary  Com. . .  Wilmington. 

Prof.  W.  L.  Poteat,  Wake  Forest  College  . Wake  Forest 

Dr.  F.  W.  Potter.  County  Sup’t  of  Health . Wilmington. 

“  J.  D.  Roberts . Durham. 

u  S.  H.  Rogers . Raleigh. 

“  W.  I.  Royster .  “ 

li  J.  J.  Summerell,  County  Sup’t  of  Health . Salisbury. 

“  R.  W.  Tate .  Greensboro. 

“  Geo.  G.  Thomas . Wilmington. 

A^A.  Thompson,  Esq.,  Mayor . Raleigh. 

Dr.  J.  H.  Tucker,  State  Board  of  Health . Henderson. 

F.  P.  Tenable,  Ph.  D  . . Chapel  Hill. 


Dr.  Tlios.  F.  Wood.  Sec’y  State  Board  of  Health ..  Wilmington. 

The  above  named,  with  but  few  exceptions,  attended  the  Con¬ 
vention.  There  were  several  others  present,  who  have  not  as 
yet  signified  their  intention  of  joining  the  Association. 


APPENDIX. 


APPENDIX. 


THE  PUBLIC  WATER  SUPPLY  OF  TOWNS  AND  CITIES  IN 

NORTH  CAROLINA. 


By  H.  T.  Bahnson,  M.  D.,  Salem,  N.  C. 

For  much  of  the  matter  of  the  following  pages  the  writer  does  not 
desire  to  claim  originality.  It  is  largely  a  collation  of  the  most  perti¬ 
nent  facts  established  by  the  researches  of  eminent  sanitary  scientists. 

The  necessity  of  a  wholesome  water-supply  for  our  growing  towns  is 
rapidly  increasing  in  importance,  and  this  paper  is  written  with  a  view 
to  point  out  imperfections,  if  any  exist,  in  such  supplies  as  are  already 
instituted,  and  to  furnish  data  which  may  serve  to  prevent  similar  and 
perhaps  graver  errors  in  future  undertakings  of  this  kind. 

If  we  study  the  history  of  modern  towns  we  will  be  struck  by  the 
fact  that  a  public  water  supply  has  generally  followed  a  more  or  less 
destructive  conflagration.  The  resulting  loss  of  property  has  induced 
property-owners  to  take  precautions  against  such  calamities  in  the  future. 
The  average  man  will  freely  tax  himself  to  insure  the  safety  of  his  house 
and  worldly  goods,  while  he  intrusts  the  lives  and  health  of  himself  and 
family  to  the  mercy  of  Providence.  If  Providence  will  preserve  from 
disease  and  death,  why  will  He  not  protect  from  fire?  Which  is  the 
worse  misfortune,  to  have  a  house  burned  down,  or  to  see  wife  and 
children  die  of  a  preventable  disease? 

Probably  these  questions  have  not  been  asked;  at  all  events,  the  prime 
object  of  a  water  supply  seems  to  be  the  protection  of  property  from 
fire.  A  town  pays  out  of  its  revenues  a  rental  upon  the  fire  hydrants 
and  the  householder  stints  his  family  in  the  use  of  water,  with  an  anxious 
eye  to  his  water-tax. 

The  old  heathen  did  better,  as  is  shown  by  the  remains  of  their  mag¬ 
nificent  acqueducts  and  public  fountains  and  baths.  Their  water  was 
used  for  cleanliness  and  the  preservation  of  health — not  to  gorge  the 
insatiable  maw  of  that  modern  municipal  toy,  the  steam  fire-engine. 
Perhaps  they  lost  more  buildings,  but  they  saved  more  lives. 

Greek  and  Roman  civilization  looked  to  the  health  and  bodily  develop¬ 
ment  of  the  citizen.  Their  religion  consisted  of  the  deification  of  heroes 
and  the  apotheosis  of  superior  physical  attributes.  In  this  religion  ablu¬ 
tions  for  the  purification  and  invigoration  of  the  body  of  the  worshippers 
bore  a  prominent  part.  In  the  revolt  against  Pagan  rites,  which  was 
brought  about  by  Christianity,  water  was  put  under  the  ban  because  of 
the  importance  attaching  to  it  in  the  heathen  ceremonial.  Self-abnega¬ 
tion  and  mortifying  of  the  flesh  took  the  place  of  personal  cleanliness 
and  attention  to  physical  culture.  Personal  nastiness  became  the  step- 


II 


APPENDIX. 


ping-stone  to  canonization,  and  the  odor  of  sanctity  was  no  figure  of 
speech.  To  the  mind  of  such  devotees,  disease  was  of  Divine  origin, 
and  plagues  and  pestilences  were  submitted  to  with  resignation.  An 
effort  to  prevent  such  visitations  would  have  been  regarded  sacrilegious. 

Out  of  this  quagmire  of  superstition  and  fanatical  perversion  of  Chris¬ 
tian  tenets  the  civilized  world  only  gradually  emerged  after  the  lapse 
of  centuries.  Dogmatism  and  cant  have  been  relegated  to  the  limbo  of 
the  Dark  Ages,  where  they  originated,  and  “pure  religion  and  undefiled ” 
again  demands  a  clean  body  as  the  abode  of  a  pure  heart.  Science,  the 
handmaid  of  religion,  has  displaced  empiricism  in  medicine,  and  inau¬ 
gurated  the  warfare  upon  filth  as  the  cause  of  disease,  which  is  the 
crowning  glory  of  this  age  of  progress  and  enlightenment.  Most  dis¬ 
eases  can  be  prevented,  some  alleviated,  and  only  a  few  cured.  The 
prevention,  therefore,  rather  than  the  cure  of  disease,  is  the  goal  of  mod¬ 
ern  medical  ambition. 

The  laws  of  life  and  health  are  daily  becoming  more  clearly  known  and 
easier  to  comprehend,  and  it  is  the  duty  of  the  physician  and  sanitarian 
to  bring  them  to  the  knowledge  of  the  authorities  and  the  public.  But 
alas!  the  traditions  and  the  prejudices  of  centuries  are  hard  to  eradicate, 
and  although  the  ear  of  this  generation  can  be  reached  by  the  propa¬ 
ganda  of  sanitation,  the  truths  of  its  teaching  usually  require  severe 
lessons  to  impress  them  upon  the  hearts  and  lives  of  a  people.-  In  spite 
of  discouragements  from  wilful  ignorance,  or  worse  still,  fatalistic 
indifference,  modern  sanitary  science  preaches  and  fights  its  crusade  for 
the  preservation  of  health  and  the  prolonging  of  life,  with  confidence 
inspired  by  a  righteous  cause  and  the  assurance  of  a  linal  victory. 

Water,  from  the  earliest  times,  has  been  regarded  as  the  symbol  of 
purity.  The  sparkling  dew  drop,  the  refreshing  rain,  the  bubbling 
spring,  the  dancing  rivulet,  the  pellucid  stream  or  lake,  the  deep,  cold 
well,  the  crystal  snow,  the  glass-like  ice.  to  the  natural  eye  present  the 
embodiment  of  purity  and  healthfulness.  It  may  be  transparent  and 
sparkling,  grateful  and  refreshing,  and  yet,  this  apparently  pure,  health- 
si'  ing  water  has  carried  in  ages  past,  and  is  to-day  carrying,  disease 
and  death  to  myriads  of  the  human  race.  Modern  science,  with  ruthless 
hands,  tears  away  the  veil  which  hides  from  our  unaided  eye  the  work¬ 
ings  of  nature’s  laboratory,  and  dispels  our  fondest  illusions.  It  teaches 
us  that  “the  moss-covered  bucket”  is  a  euphemism  for  malaria-breeding 
alga?,  and  “  the  life-giving  element”  we  so  eagerly  quaff  may  be  foul 
with  pollution  from  stable  and  privy  and  swarming  with  death-dealing 
microbes. 

Absolutely  pure  water  does  not  exist  in  nature.  Even  the  vapor  in 
the  atmosphere  which  surrounds  our  earth  is  laden  with  impurities  and 
rich  in  minute  organic  life.  The  germs  of  the  latter,  owing  to  their 
great  volatility,  are  carried  by  the  wind  to  high  altitudes  and  long 
distances:  and,  entangled  in  the  crystals  of  snow,  or  gathered  by  the 


APPENDIX. 


Ill 


globules  of  rain,  are  precipitated  upon  the  earth’s  surface.  The  red 
snott  of  Greenland,  the  wonder  of  our  school  days  geography,  derives 
its  color  from  microscopic  vegetable  spores,  and  the  so-called  “mountain 
fever”  has  been  traced  to  a  similar  origin,  viz.:  vegetable  spores  from 
the  melting  snow,  carried  into  the  springs  and  other  sources  of  water 
supply. 

But  it  is  upon  the  surface  of  the  earth,  and  the  few  feet  of  loose  soil 
which  compose  its  crust,  that  we  find  the  principal  sources  of  water, 
pollution.  Dead  and  decaying  animal  and  vegetable  matter  give  life 
and  sustenance  to  innumerable  minute  organisms,  which  we  call 
microbes.  Some  of  these  are  poisonous  in  their  influence,  while  others 
serve  as  scavengers  by  promoting  fermentation  and  putrefaction,  resolv¬ 
ing  organic  matter  into  its  chemical  constituents  and  fitting  it  to  be 
absorbed  by  the  radicles  of  growing  vegetation.  Saturated  with  decay¬ 
ing  organic  matter  and  the  products  of  its  decomposition,  the  water  not 
needed  for  vegetable  growth  either  evaporates  from  the  earth's  surface 
or  passes  into  an  adjoining  stream,  or  percolates  into  the  deeper  recesses 
of  the  earth,  until  it  is  arrested  by  some  impermeable  stratum,  from  the 
edge  of  (or  a  seam  in)  which  it  bursts  forth  again  in  the  shape  of  a 
spring.  During  its  course  through  the  deeper  layers  of  the  earth,  it  is 
constantly  undergoing  chemical  and  biological  influences.  The  products 
of  decomposition  are  thereby  further  resolved  or  eliminated  by  filtration, 
and  the  water  appears  again  at  the  surface  of  the  earth,  nearly  or 
altogether  free  from  organic  matter.  Its  purity  in  this  particular 
depends,  of  course,  upon  the  depth  and  character  of  the  filtering  mate¬ 
rial  through  which  it  has  percolated.  During  its  passage  it  dissolves 
and  carries  with  it  more  or  less,  according  to  solubility,  of  the  earthy 
and  mineral  matters  which  it  encounters.  Springs  not  being  always 
accessible  or  of  sufficient  capacity,  it  becomes  necessary  to  utilize  the 
water  from  running  streams  and  lakes  or  sink  wells  to  the  water-bearing 
stratum. 

A  spring  or  well  deriving  its  water  from  a  wooded  or  grass-covered 
arha,  protected  from  surface  drainage  and  not  holding  in  solution  an 
excess  of  mineral  or  earthy  salts,  affords  a  healthful  and  perfectly  satis¬ 
factory  water-supply.  Except  in  periods  of  great  drought,  the  small 
amount  of  its  organic  and  mineral  ingredients  would  be  no  disadvantage, 
but  only  serve  to  make  the  water  refreshing  and  palatable.  But  these 
desirable  sources  of  water-supply  can  only  exist  in  uninhabited,  or  at 
most,  sparsely  settled  sections  of  country. 

Surface  drainage  from  uncultivated  ground,  especially  if  this  be  of  a 
marshy  character,  contains  a  large  amount  of  vegetable  matter,  from 
the  decomposition  of  which,  under  certain  conditions  of  soil  and  tem¬ 
perature,  is  developed  the  malarial  poison.  It  is  positively  demonstrated 
that  this  poison  is  eliminated  from  water  by  filtration  through  the  soil, 
and  no  malarial  disease  can  be  traced  to  a  well  or  spring  untainted  by  a 


TV 


APPENDIX. 


direct  inflow  from  the  surface.  Nature’s  process  may  be  successfully 
imitated,  and  artificial  filtration,  properly  conducted,  affords  protection 
against  malarial  poison  in  drinking  water. 

As  a  country  is  settled,  however,  we  have  other  and  more  terrible  foes 
to  encounter,  in  the  effort  to  maintain  the  wholesomeness  of  our  water 
supply.  The  rotting  garbage  which  litters  our  streets  and  yards,  laundry 
and  kitchen  slops  and  waste,  the  pig-sty  and  barn -yard,  and  above  all, 
the  privy,  furnish  pabulum  for  the  development  of  the  germs  of  what 
are  known  as  zomotic  and  filth  diseases.  Their  germs  once  developed, 
permeate  the  soil,  and  it  is  only  a  question  of  time  when,  the  earth’s 
filtering  power  being  incapable  of  arresting  them,  they  invade  our 
sources  of  water  supply,  and  produce  sickness  and  death.  Amongst 
these  diseases  are  the  various  forms  of  diarrhoea  and  dysentery. 

Common  diarrhoea,  as  distinguished  from  its  specific  forms,  e.  g. , 
cholera,  occurs  generally  whenever  drinking  water  is  sufficiently  laden 
with  impurities  to  cause  irritation  of  the  alimentary  mucous  tract.  In 
periods  of  drought  and  consequent  supersaturation  with  impurities  of 
the  scanty  water  supply,  diarrhoea  and  dysentery  are  especially  preva¬ 
lent  and  attended  with  great  mortality  amongst  children  and  the  aged 
and  infirm.  That  in  most  cases,  diarrhoeas,  sporadic  and  epidemic,  are 
due  to  a  specific  poison,  acting  otherwise  than  as  a  simple  irritant,  is 
settled  beyond  a  doubt;  but  this  poisonous  principle,  almost  certainly  a 
germ,  has  not  yet  been  definitely  determined.  In  many  cases  of  diarrhoea, 
occurring  from  the  use  of  water,  the  pollution  of  the  latter  has  been  so 
great  that  its  excess  of  organic  matter  could  be  determined  by  micro¬ 
scopical  and  chemical  analysis,  and  quite  frequently  its  odor  and  taste 
sufficed  to  condemn  it  as  unfit  for  use. 

Cholera  is  a  specific  diarrhoea.  Originating  along  the  water  courses 
in  India,  where  it  is  always  endemic,  its  germs  are  carried  by  travel  and 
commerce  to  all  parts  of  the  world.  We  know  that  it  is  especially 
transmissible  by  water,  and  the  latter  may  be  contaminated  either 
directly  by  choleraic  excreta,  or  by  the  absorption  of  the  exceedingly 
volatile  germs  from  the  atmosphere.  So  rapid  is  their  dissemination 
that  neither  natural  nor  artificial  filtration  can  be  depended  upon  during 
the  prevalence  of  this  virulent  disease.  In  an  epidemic  of  cholera,  no 
water  should  be  drunk  which  has  not  been  thoroughly  boiled,  passed 
through  a  reliable  filter,  and  kept  in  an  air-tight  vessel.  Boiling  destroys 
the  germs  of  the  cholera  by  coagulating  the  albuminoids.  Filtration 
deprives  it  of  these  coagulated  albuminoids,  and  restores  its  sapidity  by 
replacing  the  air  expelled  in  boiling.  If  it  were  possible  to  adopt 
generally  the  same  precautions  at  all  times,  the  cases  of  sickness  and 
death  caused  by  unwholesome  water  would  be  reduced  to  a  minimum. 
Under  the  influence  of  a  cholera  scare,  no  expense,  no  sacrifice  of  comfort 
01  con\  enience  is  thought  too  great  to  be  rendered  as  a  free-will  offering 
at  the  shiine  of  this  awe-inspiring  ]\Ioloch.  But  cholera  rarely  visits 


APPENDIX. 


V 

our  favored  shores,  and  by  a  rigorous  enforcement  of  quarantine  regu¬ 
lations,  we  can  entirely  escape  its  ravages. 

W e  read  with  horror  of  the  desolation  wrought  by  it  a  year  ago  in 
Italy  and  Spain;  of  cities  decimated  and  abandoned  by  their  terror- 
stricken  inhabitants;  of  villages  and  whole  districts  depopulated,  the 
living  unable  to  care  for  the  sick  or  bury  the  dead.  We  note  with 
indignant  amazement  the  squalor  and  filth,  the  unsanitary  conditions 
which  aided  the  dissemination  and  augmented  the  fatality  of  the  pesti¬ 
lence,  and,  with  Pharisaical  complacency,  we  thank  God  that  we  are  not 
as  other  men  are. 

We  deliberately  close  our  eyes  to  the  fact  that  our  country  is  constantly 
ravaged  by  diseases  even  more  fatal,  and  quite  as  much  due  to  filth  as 
is  cholera,  for  their  origin  and  dissemination. 

Foremost  amongst  these  are  diphtheria  and  typhoid  fever.  Both  are 
produced  by  specific  organic  principles.  Rotting  garbage  affords  develop¬ 
ment  to  the  germs  of  diphtheria,  while  the  poison  of  typhoid  fever  has 
its  origin  in  decomposing  human  excrement.  The  former  is  frequently, 
and  the  latter  is  almost  invariably,  conveyed  into  the  system  by  drink¬ 
ing  water.  The  deaths  in  this  country  every  year  from  these  two 
diseases  outnumber  by  many  times  the  severest  epidemics  of  cholera 
or  yellow  fever.  The  latter,  confined  to  a  limited  area,  arrest  the  atten¬ 
tion,  while  the  former,  on  account  of  their  widespread  distribution,  are 
regarded  with  equanimity,  and  submitted  to  as  a  matter  of  course. 
And  yet,  they  are  more  easily  prevented  by  us  than  either  yellow  fever 
or  cholera.  The  latter  diseases  are  of  foreign  importation,  and  a  laxity 
of  quarantine,  for  which  we,  as  individuals  or  communities,  are  not 
responsible,  may  bring  one  or  both  of  them  upon  us.  Diphtheria  and 
typhoid  fever  are  home  productions — the  legitimate  fruits  of  our  own 
filth.  The  parent  who  throws  his  child  into  the  fire,  the  husband  who 
shoots  his  wife,  the  man  who  slays  his  neighbor,  is  justly  condemned  as 
a  murderer.  In  what  respect  does  he  differ  from  him  who  breeds  a 
pestilence  that  kills  his  wife,  and  child,  and  neighbor  ? 

It  is  possible  to  evade  or  contravene  human  law,  but  the  laws  of  nature 
are  immutable  and  implacable;  effect  follows  cause — crime  brings  pun¬ 
ishment.  The  penalty  may  be  delayed,  but  it  is  none  the  less  certain. 
The  foul  drain,  the  reeking  offal  from  kitchen  and  pig-sty,  invite  the 
waiting  germ  to  breed  the  pestilence  that  throttles  and  suffocates  our 
darling  child,  whose  agonizing  sufferings  we  are  powerless  to  allay 
whose  piteous  appeals  for  the  help  we  cannot  afford  rend  our  bleeding 
hearts.  The  offending  filth  may  be  in  our  neighbor’s  premises,  or  on 
the  public  highway;  this  but  shifts  the  responsibility ,  without  mitigating 
the  crime,  or  giving  immunity  from  its  penalty. 

Diphtheria,  as  a  distinct  disease,  was  first  described  in  IS, 15,  as  oiigi- 
nating  in  the  slums  of  Paris.  Since  that  time,  it  has  been  recognized  o\  e 
the  whole  civilized  world,  and  is  justly  regarded  as  the  most  fatal  pesti- 


VI 


APPENDIX. 


lence  of  modern  times.  In  the  city  of  Brooklyn,  the  mortality  during 
the  past  twelve  months  was  nearly  one  thousand,  and  in  other  parts  of 
the  country  it  claims  its  victims  in  like  or  even  greater  proportion. 

Its  transmission  by  water-pollution  is  abundantly  attested.  There  is 
no  necessity  to  go  outside  of  the  State  for  evidence.  In  Winston  and 
Salem  not  less  than  thirty  sporadic  cases  have  occurred  during  the  past 
two  years.  All  of  these  were  in  families  using  well  water.  The  sur¬ 
roundings  were  most  favorable  for  its  development— garbage  plentiful, 
and  pig-sties  numerous.  In  the  houses  of  neighbors  using  water  from 
the  public  supply  not  one  case  occurred.  It  frequently  happens  that 
diphtheria  is  prevalent  on  one  ridge  or  water  shed.  In  one  case,  under 
my  observation,  the  disease  in  the  course  of  years  traveled  about  twenty 
miles  along  one  ridge,  taking  the  lives  of  over  one  hundred  children, 
and,  except  by  contagion,  not  affecting  a  single  person  on  parallel  ridges. 
The  dreadful  epidemics,  ten  to  fifteen  years  ago,  in  Company  Shops, 
Charlotte,  Newbern  and  other  places  in  the  State,  can  only  be  accounted 
for  by  the  general  pollution  of  the  wells. 

Sanitary  science  teaches  us  that  the  virulence  of  diphtheria  can  be 
mitigated,  and  its  germs  prevented  from  propagation,  by  cleanliness  in 
our  premises  and  surroundings.  In  the  city  of  Pullman,  where  sanita¬ 
tion  is  enforced  by  law,  the  disease  is  unknown.  We  know  further, 
that  it  is  highly  contagious,  spreading  rapidly  from  the  person  and  sur¬ 
roundings  of  the  sick,  and  particularly  from  the  body  of  the  dead.  Yet 
the  dead  body  of  the  little  victim  is  often  left  exposed  to  be  gazed  at  by 
friends  and  kissed  by  relatives,  the  bedding  and  furniture  of  the  sick¬ 
room  placed  in  the  yard  to  poison  the  atmosphere,  and  the  sputa  and 
dejecta  of  the  patient  thrown  upon  the  ground  to  pollute  the  surrouding 
wells.  Isolation  of  the  sick,  thorough  disinfection,  and  prompt  sealing 
up  of  the  dead  body  will  limit  the  contagion,  and  yet  there  is  not  a  law 
on  our  statute  books  to  enforce  these  simple  and  necessary  regulations. 
Probably  more  than  one  thousand  children  in  North  Carolina  are  yearly 
sacrificed  to  this  preventable  disease  by  our  indifference  and  stupidity. 
Shall  the  blood  of  these  slaughtered  innocents  cry  out  from  the  ground 
in  vain  ? 

Typhoid  fever  is  not  a  contagious  disease  like  diphtheria.  Its  poison 
does  not  spread  from  the  person  and  surroundings  of  the  sick,  and  if 
several  members  of  a  family  or  community  are  stricken  down  by  this 
disease,  they  do  not  contract  it  directly  from  one  another.  The  poison¬ 
ous  germs  are  found  only  in  the  evacuations  from  the  bowels  of  the  sick. 
These,  thrown  upon  the  ground,  or  cast  into  the  privy,  multiply  with 
amazing  rapidity;  and,  washed  by  the  rain  into  a  stream,  or  percolating 
through  the  soil  into  a  well  or  other  source  of  water  supply,  spread  the 
disease  amongst  those  using  the  water.  Water  so  polluted  gives  no  evi¬ 
dence  of  its  fatal  properties.  Neither  by  chemical  nor  by  biological 
analysis  can  the  presence  of  typhoid  fever  germs  be  detected  with  cer- 


APPENDIX. 


VII 


tainty.  Natural  filtration  does  not  exclude  them  from  a  well,  and  it  is 
unreasonable  to  hope  that  artificial  filtration  can  do  more.  They  resist 
the  chemical  and  biological  influences  to  which  they  are  subjected  in 
passing  through  the  soil,  are  unaffected  by  frost,  and  retain  their  viru¬ 
lence  indefinitely.  The  dejecta  of  a  single  patient,  during  the  winter  of 
1884-85,  were  thrown  out  upon  the  frozen  ground,  and  by  the  thaw  in 
April  were  carried  into  the  reservoir  which  supplied  water  to  the  village 
of  Plymouth,  Pennsylvania.  In  less  than  one  month  over  seven  hun¬ 
dred,  and  in  less  than  three  months  twelve  hundred  people  using  the 
water  were  stricken  down  with  the  disease. 

Typhoid  fever  respects  neither  age  nor  sex,  and  regards  previous  con¬ 
dition  only  in  so  far  that  the  negro  race  is  perhaps  less  liable  than  the 
white  to  its  ravages.  It  flourishes  alike  in  country  and  town.  From 
the  mountain  to  the  sea-shore,  wherever  human  excrement,  directly  or 
indirectly,  finds  access  to  drinking  water,  typhoid  fever  prevails. 
Exemption  can  be  secured  only  by  having  passed  through  the  disease — 
a  second  attack  is  very  rarely  observed.  A  neighborhood  or  community 
may  for  a  long  time  escape  a  visitation,  but  sooner  or  later  its  time  will 
come,  unless  the  proper  precautions  are  taken.  An  absentee  returning 
home,  a  transient  guest,  a  child  from  school,  may  at  any  time  bring  the 
disease  from  an  infected  locality.  In  these  days  of  rapid  and  easy 
travel,  such  contingencies  are  of  every-day  occurrence. 

In  the  absence  of  a  registration  law,  we  can  only  estimate  the  mor¬ 
tality  from  typhoid  fever  in  North  Carolina  by  a  comparison  with  other 
States  which  have  such  registration.  Giving  ourselves  the  benefit  of 
every  advantage,  we  are  forced  to  conclude  that  not  less  than  five  hun¬ 
dred  of  our  citizens  annually  die  from  this  disease.  In  the  United  States 
typhoid  fever  kills  more  than  thirty  thousand  every  year,  and  we  suffer 
our  share  of  the  mortality.  For  each  death  we  may  count  at  least 
eight  sick  on  an  average  eight  weeks.  The  great  majority  of  victims 
to  typhoid  fever  are  in  beginning  maturity — the  most  valuable  and 
productive  period  of  human  life.  Such  a  life  is  certainly  worth  $1,000. 
Eight  sick  for  each  death  means  four  thousand  sick  eight  weeks  each 
year,  or  an  average  of  six  hundred  sick  every  day  in  the  year.  A  low 
estimate  of  the  loss  of  productiveness  and  the  general  and  incidental 
expenses  of  sickness  would  be  $1  per  day  for  each  patient. 

Let  us  summarize: — 


Five  hundred  deaths  at  $1,000 - 

Six  hundred  dollars  per  day  for  sickness,  305  days  . 


$500,000 

219,000 


And  we  have  a  total  of 


$719,000 


— a  sum  equal  to  the  entire  revenues  of  the  State,  ruthlessly  squan¬ 
dered  and  literally  wiped  out  of  existence — taken  from  the  lesouices  ol 


VIII 


APPENDIX. 


our  State  and  paid  for  the  questionable  privilege  of  mixing  our  own 
ordure  with  our  drinking  water. 

These  figures  are  appalling  and  may  seem  incredible,  but  let  my  reader 
examine  his  own  family  history  and  visit  the  neighboring  grave-yards, 
and  then  make  his  own  calculations.  When  he  has  accomplished  this, 
I  beg  him  to  compute  the  anxiety,  the  sorrow  and  desolation — a  task  for 
which  I  confess  myself  entirely  inadequate. 

Other  sources  of  water-pollution  deserve  more  than  the  casual  men¬ 
tion  to  which  I  limit  myself.  The  blood  and  offal  from  slaughter¬ 
houses,  the  waste  from  manufacturing  establishments,  the  refuse  from 
saw  and  planing  mills,  should,  for  obvious  reasons,  not  be  allowed  to  rot 
upon  the  ground  and  be  carried  by  storm-water  into  our  streams.  Sewage 
from  paper-mills  and  tan-yards  is  especially  objectionable,  and  the  sub¬ 
soil  drainage  from  cemeteries  is  literally  the  draught  of  death. 

Writers  upon  cholera  in  India  ascribe  its  origin  and  virulence  largely 
to  the  fact  that  the  washing  of  clothes  is  carried  on  in  the  water  which 
is  used  for  drinking.  How  often  do  we  see  the  washing  of  the  family 
done  at  the  well  or  on  the  bank  of  the  spring?  Need  we  ’wonder  if  such 
water  is  sometimes  unwholesome? 

The  importance,  nay,  the  vital  necessity,  for  a  pure  water  supply  for 
our  people,  whether  they  are  scattered  over  the  country  or  aggregated 
in  towns,  must  be  conceded.  As  towns  increase  in  population,  the  dif¬ 
ficulty  of  procuring  a  wholesome  water  supply,  and  the  dangers  of  its 
pollution,  are  correspondingly  augmented. 

It  is  asserted  that  a  barrel  of  kerosene,  poured  into  a  hole  ten  feet  in 
the  ground,  will  contaminate  all  the  wells  in  a  radius  of  a  quarter  of  a 
mile.  Sooner  or  later,  therefore,  the  poisonous  products  of  decomposing 
filth  must  find  their  way  into  a  well  in  proximity  to  a  habitation  and  its 
out  houses.  As  population  increases  in  a  given  area,  so  does  the  volume 
of  garbage  and  filth  and  excrement.  In  addition  to  this,  vegetation, 
which  would  otherwise  assist  in  its  disposal,  decreases  in  inverse  ratio 
to  density  of  population.  The  bare  ground  of  streets  and  yards  becomes 
supersaturated  with  rotting  refuse,  which  percolates  through  the  subsoil 
into  the  wells.  The  germs  of  disease  may  not  be  in  this  pitcher  full  or  that, 
but  they  will  surely  find  us  some  day  if  we  continue  to  use  the  water 
which  contains  them.  A  water-bed,  or  basin,  cannot  safely  be  used  for 
concurrent  purposes  of  w^ater  supply  and  the  reception  of  offal.  Sick¬ 
ness  and  death  will  follow  as  surely  as  the  night  succeeds  the  day.  A 
new  source  of  supply,  therefore,  must  be  sought,  and  this  is  the  question 
that  confronts  every  growing  town. 

It  is  fondly  imagined  by  many  that  the  purity  of  water  can  be  deter¬ 
mined  by  chemical  or  biological  analysis.  While  water  in  which  gross 
impurities  are  detected  by  either  process  is  justly  condemned  as  unfit  for 
use,  the  reverse  of  this  axiom  by  no  means  follows.  There  are  many 
sources  of  error,  and  I  will  mention  a  few : 


APPEND  I X. 


IX 


1st.  Water  analyzed  to-day  and  found  unobjectionable  may  easily 
become  foul  with  pollution  to-morrow.  It  is  obviously  impossible  to 
analyze  water  every  time  we  want  a  drink. 

2d.  Water  purposely  polluted  with  cholera  and  typhoid  fever  poison 
has  been  pronounced  of  good  quality  by  chemical  tests. 

3d.  Until  we  can  recognize  the  germs  of  the  various  filth  diseases,  the 
biological  analysis  of  water  can  give  only  negative  results.  There  is 
•every  reason  to  hope  that  success  will  crown  the  painstaking  efforts  now 
being  made  to  isolate  and  determine  these  poisonous  germs :  but  even 
then  their  exclusion  from  our  water  supply  must  continue  to  be  our  only 
safeguard. 

In  the  selection  of  a  water  supply,  we  should  not  be  contented  with 
an  examination  of  the  contour  of  the  water-shed.  It  must  be  remem¬ 
bered  that,  in  most  sections  of  our  State,  the  crust  of  the  earth  is  of 
very  recent  formation — the  result  of  denudation  and  atmospheric  action 
upon  the  underlying  rocks.  These  may,  and,  indeed,  generally  do,  dip 
at  a  considerable  angle  to  the  surface.  Surface  drainage  and  subsoil 
drainage,  therefore,  are  often  in  different  or  even  opposite  directions, 
and  our  calculations  as  to  the  area  which  supplies  this  or  that  water 
basin  are  frequently  at  fault.  It  must  be  evident,  then,  that  we  should 
have  an  accurate  knowledge  of  the  dip  and  strike  of  the  water-bearing 
stratum.  Nowhere  could  the  services  of  a  competent  geologist  or 
engineer  be  more  profitably  utilized  than  in  the  selection  of  a  site  for  a 
water  supply. 

North  Carolina  is  a  well  watered  State,  and  our  surface  is  not  yet 
settled  so  thickly  that  a  suitable  area  for  a  wholesome  water  supply 
•cannot  be  found,  in  most  cases,  near  a  town.  Such  localities  should  be 
secured  without  delay,  and  zealously  guarded  against  contamination. 
It  needs  no  argument  to  convince  a  thinking  man  that  this  course  is 
true  economy.  What  ought  to  be  done  should,  in  all  cases,  be  done  at 
once.  It  is  we  who  are  interested  in  this  matter,  now  in  our  own  time 
and  generation;  for  what  does  it  avail  us  that  our  town  is  supplied  with 
pure  water  ten  years  hence,  if  at  that  time  it  be  remarked  of  us:  “  Ah, 
yes,  I  remember  him  well;  he  died  of  typhoid  fever  eight  years  ago. 
And  it  is  an  easy  matter  to  so  arrange  the  financial  burden  that  part  ol 
it  shall  fall  upon  those  who  will  hereafter  participate  in  its  benefits. 

The  purity  of  the  water  should  be  the  first  consideration.  We  must 
go  to  nature  for  this,  and  take  advantage  of  her  lavish  generosity  in  this 
direction.  In  some  cases  springs  may  afford  a  sufficient  supply ,  in 
others  a  large  stream,  in  $till  others  a  neighboring  lake.  These  failing, 
it  may  be  there  is  an  impervious  stratum  below  our  polluted  water-shed, 
piercing  which,  we  find  an  abundance  of  uncontaminated  w atei .  Such 
water  is  utilized  in  Brooklyn  and  Memphis,  and  is  the  hope  of  New  hern 
and  Goldsboro  in  our  own  State. 

Whatever  the  source,  it  cannot  be  too  strongly  emphasized,  that  it 


X 


APPENDIX. 


must  be  pure,  and  must  be  kept  pure.  The  drainage  area  of  the  supply 
must  be  kept  under  the  closest  supervision,  and  the  health  authorities 
empowered  to  protect  the  many  against  the  careless  or  wanton  encroach¬ 
ments  of  the  few. 

Next  in  importance  to  purity  is  abundance  of  water  supply.  It  has 
been  well  said  that  the  true  test  of  civilization  is  the  consumption  of 
water  for  domestic  purposes.  Although  custom  sanctions  the  practice, 
it  is  manifestly  unwise,  as  well  as  unjust,  to  levy  a  tax  on  water  for 
domestic  use,  and,  without  money  and  without  price  to  the  owner,  pour 
a  hundred  or  a  thousand  times  as  much  into  a  burning  building.  Such 
a  tax  bears  unequally  upon  the  people,  and  is,  in  the  case  of  the  very 
poor,  prohibitory.  The  latter,  if  possible,  avoid  using  the  taxed  water, 
and  resort  to  suspicious,  if  not  certainly  polluted,  private  sources  of  sup¬ 
ply.  A  revolution  of  the  present  system  can  hardly  be  brought  about 
immediately,  but  such  a  reduction  of  charges  as  will  enable  even  the 
poorest  to  make  ample  use  of  pure,  wholesome  water  is  a  sanitary  neces¬ 
sity,  and  deserves  the  earnest  consideration  of  town  authorities  every¬ 
where.  Sickness  is  impoverishment,  health  is  wealth  ;  and  not  only  is 
the  good  name  of  a  town  injured,  but  the  lives  and  health  of  the  better 
classes  are  imperilled  if  filth  diseases  prevail  among  the  poor. 

The  introduction  of  a  w  holesome  and  abundant  v\  ater  supply  into  a 
town  is  simply  a  question  of  money — not  what  it  costs  to  obtain,  but 
what  it  costs  to  do  without.  The  inhabitants  of  a  town  must  be  short¬ 
sighted  indeed,  if  they  hesitate  at  any  outlay  which  will  prevent  dis¬ 
ease,  increase  their  health  and  longevity,  correspondingly  augment  their 
productive  activity,  and  lessen  their  death-rate. 

Vienna,  in  one  year,  decreased  her  mortality  by  typhoid  fever  from 
341  to  11  per  100.000  by  introducing  spring-water  in  place  of  that  drawn 
from  the  Danube  river.  Baltimore,  Brooklyn,  Memphis  and  other 
American  cities  have  done  equally  well.  How  long  would  it  take  such 
a  saving  of  life  and  health  to  balance  the  cost  of  the  most  expensive 
water- works? 

Bad  water  affords  a  valid  pretext  for  the  use  of  alcoholic  liquors  to 
prevent  ics  poisonous  effects.  If  our  prohibition  friends  deprive  the  poor 
man  of  his  tipple,  they  should  certainly  aid  in  providing  something  more 
wholesome  to  supply  its  place.  Apart  from  the  encouragement  and 
quasi- justification  for  the  use  of  intoxicating  beverages  which  unwhole¬ 
some  water  furnishes,  it  is  an  established  fact  that  polluted  water  causes 
more  deaths,  more  sickness,  more  sorrow,  misery  and  destitution  than 
all  the  stills  in  the  State. 

Sanitation  prescribes  temperance  in  all  things,  and  positive  avoidance 
of  morbific  agencies.  Compared  to  it,  prohibition  is  a  rush-light  to  the 
sun,  an  episode,  a  side-show  to  a  great  caravan.  Sanitation  once 
established  as  a  governing  principle  in  State  and  family,  prohibition 


would  naturally  become  a  question  of  expediency  to  an  elevated  and 
enlightened  public  sentiment. 

As  has  been  mentioned  above,  the  introduction  of  a  public  water  sup¬ 
ply  has  generally  been  with  a  view  to  protection  from  fire.  Indeed,  until 
within  the  past  forty  years,  a  connection  between  drinking-water  and 
specific  forms  of  disease  was,  at  best,  only  suspected.  Since  sanitary 
science  has  positively  demonstrated  this  causative  relation,  various  expe¬ 
dients  have  been  adopted  in  a  futile  effort  to  correct  and  remedy  the 
impurities  which  are  known  to  exist  in  established  water  supplies. 

A  brief  mention  of  these  expedients  may  prove  interesting.  The 
principal  ones  are  sedimentation,  aeration,  chemical  precipitations,  and 
various  modifications  and  combinations  of  these  processes.  All  of  these 
are  imitations  of  natural  processes,  and,  of  necessity,  as  imitations,  fall 
short  of  the  original. 

Sedimentation  takes  place  naturally  in  lakes  and  streams,  and,  on  a 
smaller  scale,  in  wells  and  springs.  The  particles  of  earthy  matter, 
from  their  own  weight,  subside  to  the  bottom,  and  along  with  them  more 
or  less  of  organic  impurities.  Storage  reservoirs  possess  this  advantage, 
and  necessarily  add  much  to  the  appearance  and  healthfulness  of  the 
water,  their  good  effect  being  proportionate  to  their  capacity  and  the 
length  of  time  water  is  exposed  to  their  influence.  In  seasons  of  unusual 
turbidity,  no  less  than  ten  tons  of  earthy  matter  and  one-half  ton  of 
decomposing  organic  substances  are  thus  eliminated  from  the  20,000,000 
gallons  of  lake- water  which  constitute  the  daily  supply  of  Cleveland, 
Ohio.  That  the  elimination  of  such  a  mass  of  putrescent  filth  is  of  the 
greatest  advantage  must  be  self-evident.  Nevertheless,  sedimentation 
is  but  a  poor  safeguard  against  disease.  The  infected  water  which  pros¬ 
trated  twelve  hundred  of  the  eight  thousand  inhabitants  of  Plymouth, 
Pennsylvania,  and  killed  one  hundred  and  thirty,  passed  through  three 
storage  reservoirs  to  accomplish  its  deadly"  mission.  Sedimentation  is 
limited  in  its  value  and  adaptability,  and  care  must  be  taken  to  prevent 
stagnation  in  storage  reservoirs. 

Every  one  has  noticed  the  greenish  scum  which  generally  covers  a 
stagnant  pond.  If  we  follow  the  effluent  of  such  a  pond,  we  notice 
that  very  speedily  the  water  becomes  clear  and  sparkling,  especially  if 
there  is  enough  descent  to  cause  ripples  or  falls  in  the  stream.  rl  his 
process  has  been  successfully  imitated  by  forced  aeration  in  some  storage 
reservoirs,  notably  at  Brooklyn,  New  ^  ork,  where  stagnation  produced 
such  a  scum,  and  the  filthy  water  was  restored  to  a  potable  condition. 
The  decomposition  and  destruction  of  the  vegetable  matter  composing 
the  scum,  was  effected  by  the  oxygen  in  the  air  forced  through  it. 

Chemical  precipitation  by  means  of  alum,  various  salts  of  iron,  lime, 
etc.,  etc.,  is  a  useful  adjumant  to  sedimentation  and  filtration.  It  is 
not  necessary  to  inquire  whether  the  action  of  these  agents  is  strictly 
chemical,  or  in  part  mechanical.  They  undoubtedly  hasten  the  subsi- 


XII 


APPENDIX. 


dence  of  the  grosser  organic  and  inorganic  impurities  suspended  in 
water,  but  cannot  be  depended  upon  to  eliminate  the  specific  germs  of 
disease.  These  are  so  tenacious  of  their  vitality  that  their  destruction 
•could  be  accomplished  only  by  an  amount  of  purifying  agents,  which 
would  be  of  itself  dangerous  to  human  life. 

Artificial  filtration  consists  of  the  passage  of  water  through  beds  of 
gravel,  charcoal,  coke  or  other  porous  substances.  Theoretically,  it  is 
the  most  promising  means  for  purifying  water,  and  the  result  of  the 
process,  if  properly  conducted,  is  most  gratifying  to  the  eye  and  taste  of 
the  consumer;  a  perfectly  limpid,  appetizing  water.  The  defect  in 
artificial  filtration  is  that  it  undertakes  a  thousand  or  even  a  million 
fold  as  much  as  nature.  It  has  neither  the  time  nor  the  surface  to  effect 
percolation  after  nature’s  method.  More  water  passes  through  a  filter¬ 
ing  bed  under  strong  pressure  in  an  hour  than  nature  purifies,  on  the 
same  area,  in  one  or  more  years.  Some  filters  are  arranged  for  a  reversal 
of  current  and  a  scouring  of  the  filtering  material,  and  it  is  claimed  that 
they  are  thus  thoroughly  cleansed.  But  who  can  confidently  assert  that 
such  reversed  current  and  even  scouring  will  remove  all  the  minute 
impurities  which  have  been  forced  against  the  surface  or  entangled  in 
the  interstices  of  the  filtering  material?  It  is  not  denied  that  some 
organic  matter  remains  after  filtration,  and  it  is  only  a  natural  infer¬ 
ence,  that  owing  to  their  minute  size  and  great  vitality,  the  germs  of 
disease  shall  longest  and  most  successfully  resist  elimination.  The 
guarantee  of  a  patent  filtering  company  is  worthless  from  a  scientific, 
sanitary  standpoint.  A  crucial  test  would  be  the  prolonged  use,  by 
themselves  and  families,  of  water  impregnated  with  typhoid  and 
diphtheritic  germs,  and  passed  through  their  filter.  They  ought  to  have 
at  least  as  much  faith  in  their  assertions  as  is  shown  by  the  veterina¬ 
rian  in  England,  who  declares  that  hydrophobia  exists  only  in  the 
imagination  of  its  victims,  and,  up  to  last  accounts,  had  allowed  himself 
to  be  bitten  by  147  rabid  dogs. 

Filtration  will  probably  remove  malarial  poison,  and  suffice  to  purify 
for  drinking  purposes  the  water  from  lakes  and  rivers.  If  these  are  of 
large  size,  we  might  reasonably  hope,  that  if  pollution  existed  it  would 
be  so  diluted  in  a  vast  body  of  water  as  to  be  innocuous.  And  yet, 
Chicago,  which  derives  it  water  supply  from  Lake  Michigan,  through  a 
tunnel  opening  two  miles  from  the  shore,  is  about  to  extend  the  tunnel 
three  miles  further  out  to  insure  exemption  from  pollution. 

The  sum  of  our  knowledge  on  the  subject  of  artificial  purification  of 
water  is  thus  tersely  expressed  by  the  English  Commissioners:  “  Of  all 
the  processes  which  have  been  proposed  for  the  purification  of  water 
polluted  by  excrementitious  matters,  there  is  not  one  which  is  sufficiently 
effective  to  warrant  the  use,  for  dietetic  purposes,  of  water  which  has 
been  so  contaminated.” 

We  may  add:  Water  to  which  sewage  has  access,  directly  or  indi- 


APPENDIX. 


XIII 


rectly,  by  surface  or  subsoil  drainage,  should,  from  that  fact  alone,  be 
excluded  from  all  consideration  as  a  possible  source  of  water  supply  for 
drinking  purposes. 

The  sanitary  requirements  of  a  public  water  supply  are  only  two  in 
number,  viz.: 

First.  Purity — i.  e. ,  absolute  freedom  from  apparent  and  possible,  both 
present  and  future,  contamination  and  pollution.  This  necessitates 
undisputed  control  and  watchful  supervision  of  the  water-shed  and  the 
surface  area  supplying  it. 

Second.  Quantity — i.  e.,  water  in  sufficient  abundance  and  cliead 
enough  to  be  used  freely  for  domestic  purposes  by  all  classes.  This 
requirement  can  only  be  met  when  the  water  works  are  owned  by  the 
town.  Such  ownership  would  result  in  the  closing  of  private  wells  and 
springs,  which  are  always  liable  to  pollution. 

Let  us  summarize  the  reports  of  the  various  public  water  supplies  in  the 
State,  as  furnished  me  by  friendly  correspondents,  and  see  how  these 
requirements  are  fulfilled. 

Asheville. — Water  taken  from  Swannanoa  River,  four  miles  above  city. 
Stream  is  large,  rising  in  the  Black  Mountains  and  flowing  through  a 
sparsely-settled  and  cultivated  valley.  Water  occasionally  turbid  from 
rains.  Filtered  by  Hyatt  method,  a  combination  of  filtration  with 
forced  aeration  and  chemical  sedimentation.  Supply  abundant.  Works 
owned  by  the  city.  Meter  rates,  25c.  per  1,000  gallons.  Average  cost 
per  year  for  a  family  of  six  persons,  $10.  Not  yet  in  general  use  by 
poorer  classes.  Water  introduced  only  a  year  ago,  but  since  its  introduc¬ 
tion  a  marked  decrease  of  typhoid  fever  and  enteric  diseases  is  noted. 

Charlotte. — Water- works  established  1881-82.  Owned  by  a  company. 
Source  of  supply  on  outskirts  of  town,  from  several  small  streams  and 
ponds;  also  surface  water.  Storage  reservoirs  of  16.000,000  gallons 
capacity.  Water  often  muddy  and  liable  to  pollution,  as  company  has 
control  of  only  a  small  area  of  water-shed.  Average  consumption, 
265,000  gallons  per  day— a  little  over  one-fourth  capacity.  Water  rates, 
50c:  per  1,000  gallons.  Average  cost  per  year  for  a  family  of  six  per¬ 
sons,  $20.  Not  in  general  use  by  poorer  classes,  but  increased  health¬ 
fulness  noticed  among  consumers. 

Concord. — Supply  taken  from  a  remarkably  pure  spring  near  centre 
of  town.  No  apparent  connection  with  immediately  surrounding  area. 
Capacity,  about  thirty  thousand  gallons  per  day.  A  orks  owned  by 
private  individual.  Water  not  in  general  use. 

Durham. — Works  owned  by  a  company.  Water  introduced  two  years 
ago.  Supply  derived  from  several  springs,  six  miles  north  of  town, 
whose  waters  are  impounded  and  collected  into  a  reservoir.  Surround¬ 
ing  country  hilly  and  rocky,  with  sandy  surface  and  clay  subsoil.  No 
habitations  near.  Reservoir  closely  fenced  and  whole  works  guaided. 
Water,  after  heavy  rains,  slightly  turbid  from  clayey  sediment.  (  apacit\ 


XIV 


APPENDIX. 


four  times  greater  than  is  demanded  by  present  size  of  town.  Water  is 
pretty  generally  used— at  least,  by  better  classes.  Meter  rates,  40c.  per 
1,000  gallons.  Average  cost  per  year  for  family  of  six  persons,  $16. 

Fayetteville.— Present  system  of  water-works  introduced  in  1824. 
Belongs  to  town.  Supply  is  from  springs  just  outside  corporate  limits. 
Water  collected  in  a  brick  reservoir  and  conveyed  through  bored  logs, 
connected  by  iron  couplings.  Capacity  about  eighty-five  thousand  gal¬ 
lons  per  day.  In  limited  use.  Rates,  . . 

Goldsboro—  No  public  water  supply.  Contract  entered  into  by  city 
with  a  Northern  company  to  supply  2,000,000  gallons  per  day  at  a  price 
for  family  consumption  of  $5.50  per  faucet,  making  average  cost  pei 
year  for  a  family  of  six  persons  at  least  $15.00.  Supply  to  be  taken,  if 
possible,  from  driven  wells  sunk  below  underlying  marl  stratum.  This 
would  probably  be  unobjectionable,  but  if  water  is  taken  from  Little 
River  its  wholesomeness  is  questionable. 

Greensboro. — Works  established  during  the  past  year  and  belong  to  a 
company.  Supply  taken  from  springs  one  and  one-half  miles  from 
centre  of  town,  and  beyond  a  creek,  so  as  to  be  free  from  town  drainage. 
Area  supplying  springs  belongs  to  a  private  individual,  with  no  dwell¬ 
ings,  and  mostly  covered  with  forest.  Supply  limited  and  not  yet  much 
used.  Water  often  muddy,  ascribed  to  newness  of  storage  reservoir, 
but  as  company  proposes  putting  in  a  filter,  there  is  probably  surface 
drainage.  Meter  rates  not  to  exceed  25  cents  per  1,000  gallons.  Average 
cost  per  year  for  a  family  of  six  persons  $10.00. 

Raleigh. — Works  owned  by  company.  Supply  taken  from  Walnut 
Creek,  above  any  possible  inflow  of  city  drainage.  Area  of  water-shed 
extensive,  embracing  both  cultivated  and  woodland,  and  including  part 
of  the  village  of  Cary.  Special  legislation  has  been  obtained  for  the 
protection  of  stream  and  water-shed,  but  its  great  extent  renders  proper 
supervision  difficult,  if  not  impossible.  Capacity  ample  for  present 
needs.  Direct  service  from  pumps,  with  stand-pipe  pressure  for  fire 
protection.  Water  filtered  by  Hyatt  method.  Storage  reservoir  for 
filtered  water.  Meter  rates,  40  cents  per  1,000  gallons.  Average  cost 
per  year  for  family  of  six  persons  $16.00. 

Salem. — Water-works  first  established  over  one  hundred  years  ago. 
Supply  taken  from  springs  of  limited  capacity  and  distributed  in  cisterns 
throughout  the  village.  Superseded  by  present  system  in  1878.  Works 
owned  by  a  company.  Supply  derived  from  shallow  wells,  alongside 
the  course  of  a  stream  which  drains  a  section  of  Winston  and  Salem. 
Water  always  clear  and  tests  have  failed  to  detect  connection  with 
stream,  or  surface  drainage.  Storage  reservoir  for  fire  protection;  direct 
service  for  ordinary  consumption.  Rates,  50  cents  per  1,000  gallons. 
Average  cost  per  year  for  family  of  six  persons  $20.00.  Absence  of 
zymotic  diseases  noted  among  consumers. 

Salisbury. — Works  owned  by  a  company.  Supply  taken  from  Cane 


APPENDIX. 


XV 


Creek ,  two  miles  southeast  of  town,  away  from  town  drainage.  Area 
supplying  creek,  largely  cultivated  ground.  Water  muddy  and  not  used 
for  drinking  purposes. 

Wilmington.— Works  owned  by  a  company.  Water  taken  from 
Northeast  River  at  its  junction  with  the  Cape  Fear.  River  450  feet  wide 
at  site  of  pumping-station.  Subject  to  tidal  influences.  Located  one 
mile  or  less  above  docks,  shipping  and  sewers,  and  receives  drainage 
from  several  cemeteries,  slaughter-houses  and  a  large  part  of  the  city, 
through  a  creek  emptying  into  Northeast  River  one  quarter  of  a  mile 
above  works.  Rice  fields  on  opposite  side  of  river,  and  large  guano 
works  one  mile  above  on  Cape  Fear  river.  Water  discolored  from 
swamps  (cypress  water),  as  is  the  case  with  nearly  all  river  and  pond 
water  in  Eastern  Carolina.  Supply  unlimited.  In  only  limited  use  for 
drinking  purposes,  though  doubtless  far  more  wholesome  than  the  water 
in  private  wells.  Meter  rates,  20  cents  per  1,000  gallons.  Average  cost 
per  year  for  family  of  six  persons,  $10.00. 

Winston — Works  owned  by  a  company.  Supply  derived  from  shallow 
wells  alongside  of  a  stream  draining  mostly  cultivated  lands  and  old 
fields,  and  receiving  surface  water  from  the  suburbs  of  Winston.  A 
dam  across  the  stream  and  above  the  wells  arrests  its  flow  and  serves  for 
pumping  purposes.  Water  never  muddy,  and  tests  have  failed  to  show 
any  connection  with  adjoining  stream.  Supply  more  than  equal  to 
demand.  Water  not  in  general  use  by  poorer  classes.  Absence  of 
zymotic  diseases  noted  amongst  consumers.  Meter  rates,  50  cents  per 
1,000  gallons.  Average  cost  per  year  for  family  of  six  persons,  $20.00. 

As  a  model  for  comparison,  I  wish  to  describe  the  water  supply  of  the 
Western  North  Carolina  Insane  Asylum.  The  water  is  taken  from  an 
impounded  mountain  stream,  six  miles  from  the  asylum.  The  entire 
surface  area  of  water-shed,  which  is  covered  with  forest,  is  owned  and 
guarded  by  the  asylum  authorities.  Supply  is  ample  for  the  present 
needs,  and  can  be  nearly  doubled  by  erecting  storage  tanks  in  the  upper 
part  of  the  building.  Service  is  direct,  with  a  constant  flow,  and  the 
water  is  free  to  the  consumers. 

Approaching  nearest  to  the  model  set  by  the  Western  North  Carolina 
Insane  Asylum,  we  must  place  the  Asheville  water  supply.  Until  the  val¬ 
ley  of  the  Swannanoa  is  well  settled,  the  risk  of  pollution  may  be  excluded, 
and  the  naturally  pure  water  has  the  advantage  of  aeration  afforded  by 
the  swift  mountain  stream.  Durham  and  CIreensboroA  are  next  in  the 


*Since  writing  the  above,  I  am  informed  that  the  impounding  lesei  voii  oi 
the  Greensboro  water  works  is  part  of  an  old  mill  pond,  from  the  main  body  of 
which,  and  the  stream  supplying  it,  it  is  separated  only  by  a  bank  ol  muck  and 
earth  taken  out  for  the  purpose  of  deepening  it.  This  reservoir  is  liable  to  ovei- 
flow  of  back-water,  and  is  partly  supplied  by  seapage,  from  both  pond  and 
stream.  Such  being  the  case,  Greensboro  must  be  placed  lai  down  on  the  list 
of  doubt  ful  or  dangerous  water  supplies. 


XVI 


APPENDIX. 


list,  their  water-sheds  only  requiring  watchful  supervision  to  maintain 
their  integrity.  They  are  at  present  virtually  under  control  of  the  water 
companies  and  need  only  to  become  actually  their  property  to  fulfill  the 
first  requirement  demanded  by  sanitation.  Raleigh's  supply  depends 
for  its  safety  upon  the  permanency  of  the  lively  appreciation  of  danger 
at  present  evinced  by  its  health  authorities. 

Leaving  Concord  and  Fayetteville  out  of  consideration,  because  their 
supply  is  too  limited  to  be  generally  utilized,  we  are  compelled  to  place 
Winston,  Salem,  Salisbury,  Charlotte  and  Wilmington  in  the  doubtful 
list  of  water  supplies,  their  risk  from  pollution,  and  their  inability  to 
avert  the  danger,  increasing  in  the  order  in  which  they  are  mentioned. 
Without  legislation  they  are  all  powerless  to  protect  their  water  supply, 
while  the  last  mentioned  is  besides  at  the  mercy  of  influences  beyond 
human  control. 

How  well  the  second  requirement  is  met  I  leave  my  readers  to  decide. 
How  many  poor  families  in  our  North  Carolina  towns  can  afford  to  pay 
a  yearly  water  tax  of  $15  or  $20,  especially  when  it  is  considered  that  a 
plumber’s  bill  of  at  least  equal  amount  must  precede  the  introduction  of 
water  to  their  premises? 

I  would  not  detract  an  iota  from  the  praise  justly  merited  by  the 
public-spirited  citizens  who,  realizing  the  necessity  of  their  towns,  and 
impatient  with  the  apathy  of  municipal  authorities  and  the  general 
population,  have  invested  their  private  means  in  the  laudable  undertak¬ 
ing  to  provide  better  protection  from  fire  and  superior  water  facilities. 
It  is  only  just  that  these  public  benefactors  should  reap  some  rewrard 
besides  the  approval  of  a  good  conscience,  and  no  man  can  grudge  them 
the  small  dividends  that  are  usually  returned  by  such  investments. 

I  can  only  repeat,  that  to  enable  all  classes  to  make  sanitary  use  of  our 
public  water  supplies,  the  cost  must  be  very  much  cheapened  from  the 
present  figures,  and  the  only  way  to  accomplish  this  result,  wdthout 
injury  and  loss  to  individuals,  is  to  vest  the  ownership  of  public  water¬ 
works  in  the  town  or  city  supplied  by  them. 

If  I  have  been  followed,  it  must  be  evident  that  individual  effort  to 
preserve  the  purity  of  a  water  supply  will  not  avail.  Your  well  or 
spring  may  become  polluted  by  your  neighbor’s  privy  or  filthy  premises, 
in  spite  of  the  strictest  attention  to  cleanliness  on  your  own  domain. 
We  have,  to  be  sure,  laws  for  the  abatement  of  nuisances,  and  anything 
prejudicial  to  health  may  be  complained  of,  and,  if  proved  a  nuisance, 
removed  by  process  of  law7.  The  history  of  the  expensive  and  prolonged 
litigations  for  the  draining  of  mill-ponds  in  various  localities  in  the  State 
may  be  cited  as  instances  of  the  cumbersome  and  inefficient  action  of 
the  law.  In  practice,  the  law  has  become  a  prolific  field  for  quarrels 
and  feuds,  and  an  effective  means  to  exhibit  spite  and  ill-will.  It  is 
often  more  honored  in  the  breach  than  in  the  observance,  and  many  a 


APPENDIX. 


XVII 


man  risks  the  lives  and  health  of  himself  and  family  rather  than  com¬ 
plain  of  the  filthy  habits  and  practices  of  his  neighbors. 

Whether  sanitary  laws  are  disobeyed  through  ignorance,  carelessness  or 
perversity,  by  yourself  or  your  neighbor,  punishment  comes,  and  is  as  apt 
to  strike  the  innocent  as  the  guilty.  Indeed,  in  many  instances,  it  is  the 
innocent  especially  who  suffer,  for  it  seems  that  there  is  to  some  extent 
an  immunity  from  filth  diseases  in  individuals  and  families  who  do  not 
know  what  it  is  to  be  clean.  They  become,  as  it  were,  acclimated  to 
their  surroundings,  and  thrive  in  a  filth  which  would  sicken  and  kill 
more  sensitive  and  highly  organized  natures.  To  these  they  become 
producers  and  purveyors  of  diseases  from  which  they  may  be  themselves 
exempt. 

Communities  demand  protection  from  such  influences,  and  appoint 
sanitary  inspectors  and  boards  of  health,  but  by  limiting  their  expendi¬ 
tures  and  crippling  their  executive  powers  by  restrictive  legislation,  the 
object  and  aim  of  their  existence  is  thwarted,  if  not  entirely  abrogated. 

For  the  successful  conduct  of  any  business,  a  knowledge  of  his  duty, 
executive  ability  and  responsibility  are  required  of  an  employee.  How 
much  more  are  these  necessary  in  the  maintenance  of  life  and  health — 
the  business  of  mankind  in  this  world,  next  in  importance  only  to  the 
salvation  of  the  soul?  Yet.  how  often  do  we  see  in  a  community  a 
health  officer  appointed,  not  for  his  knowledge  and  fitness  for  the  duty, 
but  because  his  services,  such  as  they  are,  can  be  obtained  for  the  least 
money?  Some  communities,  indeed,  have  no  health  officer,  but  entrust 
their  sanitation  to  the  mercy  of  a  sanitary  policeman,  usually  an  igno¬ 
rant  hireling,  whose  principal  recommendation  is,  perhaps,  his  known 
disregard  for  the  nuisances  he  is  expected  to  abate. 

That  we  may  know  what  we  are  about,  we  should  first  ascertain  the 
facts  as  to  the  existence  and  prevalence  of  disease  in  our  State.  While 
it  may  prove  difficult,  perhaps  impossible,  to  carry  out  in  the  rural  dis¬ 
tricts,  a  system  of  death  records  and  burial  certificates  should  be  enforced 
in  every  incorporated  community,  and  the  presence  of  contagious  and 
infectious  disease  immediately  reported  to  the  constituted  authorities. 
The  physician  who  attends  a  case  of  such  disease  should  be  held  respon¬ 
sible  for  its  isolation  and  the  disinfection  of  the  excreta  and  surround¬ 
ings  of  the  patient.  In  this  way  only  can  our  atmosphere  and  soil  and 
water  be  kept  free  from  the  germs  which  cause  and  propagate  disease. 
The  health  officer  must  prevent  the  accumulation  and  superintend  the 
removal  of  garbage  and  filth,  including  the  contents  of  closets  and  cess¬ 
pools,  in  private  as  well  as  public  premises.  To  accomplish  this,  he  must 
be  clothed  with  indisputable  authority,  and  penalties  should  attach  to 
those  who  obstruct  him  in  his  work,  as  well  as  to  his  failure  to  carry  out 
these  essential  sanitary  regulations.  Returns  at  stated  intervals  should 
be  made  to  the  State  Board  of  Health,  one  of  whose  functions  it  should 
be  to  direct  and  control  the  enforcement  of  the  sanitary  laws  and  hold 

•2 


XVIII 


APPENDIX. 


to  personal  accountability  its  transgressors.  As  at  present  constituted, 
the  State  Board  of  Health  is  simply  an  advisory  body,  with  no  executive 
powers  and  only  limited  responsibility. 

The  public  water  supplies  should  be  guarded  with  especial  care  by  the 
local  authorities,  but  in  many  instances  these  would  be  powerless  with¬ 
out  the  co  operation  of  the  authorities  of  the  State.  This  is  shown  by 
the  action  of  Raleigh  in  securing  special  legislation  to  prevent  the  pollu¬ 
tion  of  its  source  of  water  supply.  Without  such  legislation,  every 
public  water  supply  in  the  State,  located  outside  the  corporate  limits  of 
a  town,  is  completely  at  the  mercy  of  every  ignorant  or  wanton  trespasser. 
In  Massachusetts,  the  law  prohibits  the  drainage  of  any  polluted  sub¬ 
stance  into  a  stream  within  twenty  miles  above  the  place  where  it  is 
used  for  a  water  supply,  and  gives  the  supervision  of  public  water  sup¬ 
plies  to  the  State  Board  of  Health.  The  approval  of  the  board  is  a  legal 
requirement  for  the  introduction  of  every  system  of  water  supply  or 
sewerage. 

The  report  of  the  committee  on  the  pollution  of  water  supplies 
which  was  read  at  the  annual  meeting  of  the  American  Public 
Health  Association  at  Milwaukee,  Wisconsin,  November  20th-23d,  1888, 
and  from  which  I  have  made  some  extracts  in  this  paper,  concludes : 
“  It  is  the  well  considered  belief  of  this  Association  that  it  is  an  impera¬ 
tive  necessity,  that  State  Legislatures  should  give  their  boards  of  health 
^hat  financial  support  which  would  enable  them  to  act  intelligently  on 
all  questions  pertaining  to  the  public  water  supply,  investing  them  at 
the  same  time  with  the  supervision  of  the  said  supplies,  at  d  with  power 
to  preserve  these  waters  from  contamination  by  sewage  or  other  injuri¬ 
ous  matters.” 

It  may  be  objected  that  a  sanitary  law,  such  as  I  have  outlined,  would 
be  too  costly.  It  may  cost  the  one  hundredth  part  of  what  is  annually 
lost  to  the  State  by  typhoid  fever  alone,  and  perhaps  approximate  or 
possibly  slightly  exceed  the  one  four  hundredth  part  of  the  entire  loss 
by  preventable  diseases.  If  it  did  not  annually  save  one  hundred  times 
its  cost,  it  would  be  a  dismal  failure. 

If  we  look  at  what  has  been  accomplished  elsewhere,  these  statements 
will  not  seem  unwarranted.  In  Michigan  the  saving  of  life  from  scarlet 
fever  in  the  last  eleven  years  amounted  to  3,718;  and  in  1886  appropriate 
sanitary  measures  saved  the  lives  of  298  persons,  who,  under  the  usual 
^conditions,  and  according  to  former  epidemics,  would  have  died  of 
diphtheria  in  a  few  localities.  In  Memphis,  the  death-rate  has  been 
reduced  in  six  years  from  35  per  1,000  to  23.8  per  1,000.  In  Chicago,  the 
death-rate  has  been  reduced  in  the  last  five  years  from  26  to  19.46  per 
1,000,  a  saving  of  nearly  20,000  lives. 

Let  us  take  a  lesson  from  Florida.  Last  winter  a  case  ef  yellow  fever 
was  smuggled  into  Key  West.  There  was  only  a  nominal  board  of 
health  in  the  State,  and  the  physician  who  attended  the  patient,  just  as 
is  the  case  in  our  State,  was  under  no  responsibility  to  report  the  nature 


APPENDIX. 


XIX 


of  the  disease.  Other  cases  appeared  in  various  parts  of  the  State,  and 
the  facts  were  suppressed.  It  was  nobody’s  business  to  let  the  truth  be 
known.  Need  I  recall  the  tenor  and  panic  of  the  people  of  Florida,  the 
horrified  amazement  of  the  rest  of  the  country  when  it  learned  that  nearly 
the  whole  State  was  infected  by  the  dreaded  pestilence  ?  Leaving  out 
the  deaths  and  sickness,  the  mere  money  loss  to  the  State  from  the 
suspension  of  business  and  the  depreciation  of  the  value  of  property,  can 
only  be  reckoned  by  millions,  while  the  confidence  of  the  civilized  world 
received  a  shock  from  which  it  will  take  years  to  recover.  A  properly 
constituted  board  of  health  would  have  had  timely  notice  of  the  first 
case,  and  stamped  out  the  disease  before  it  became  epidemic.  It  is 
needless  to  say  that  the  first  care  of  the  Florida  Legislature  will  be  the 
establishment  of  a  model  State  board  of  health. 

Until  the  year  1885  the  Legislature  of  the  great  State  of  Pennsylvania 
entertained  the  quite  prevalent  opinion  that  sanitation  was  a  local  affair, 
and  restricted  their  sanitary  legislation  to  the  larger  cities.  Then  came 
the  Plymouth  epidemic,  and,  as  a  result,  a  State  board  of  health.  Do 
we  in  this  State  need  a  similar  lesson? 

The  North  Carolina  Board  of  Health  need  the  moral  and  financial 
support  of  the  people  of  the  State  to  carry  out  their  mission.  If  these 
are  given  grudgingly,  only  niggardly  returns  can  be  expected.  Give 
them  enough  to  prosecute  their  noble  work,  and  if  they  fail  to  fulfill 
their  promise  and  your  expectations,  they  will  deserve  to  be  cast  out  as 
unprofitable  servants. 

The  moral  aspect  of  sanitation  has  been  incidentally  touched  upon. 
If  I  point  a  loaded  pistol  at  a  fellow-man,  and  pull  the  trigger,  I  commit 
a  murder.  If  I  knowingly  allow  that  man  to  be  exposed  to  a  disease 
which  takes  his  life,  am  I  innocent  of  his  death :  Human  law  may 
enonerate  me,  but  how  can  I  plead  at  the  bar  of  God  and  my  own  con¬ 
science?  The  laws  of  life  and  health  are  plain  and  simple.  They  are 
the  laws  of  God ;  we  know  them ;  happy  are  we  if  we  do  them.  The 
time  has  come  in  modern  civilization  when  ignorance  and  indiffeience 
cannot  be  pleaded  in  excuse  for  neglecting  the  enactment  and  enfoi  ce¬ 
ment  of  sanitary  laws. 

In  ghastly  mockery  of  the  words  of  hope  and  resignation  graven  on 
the  tombstones  of  our  loved  ones,  who  have  succumbed  to  pieventable 
diseases,  we  see  standing  out  in  letters  of  fire,  which  should  scoicli  and 
sear  our  consciences :  ‘  ‘  Strangled  by  filth  !  ‘  ‘  Killed  by  wilful  ignorance 

and  neglect !” 

The  deaths  from  preventable  diseases  in  this  State  are  simply  muideis, 
and  we  are  left  to  decide  in  how  far  each  of  us  is  answerable  to  the  just 

Judge  of  all  for  the  crime. 

The  ignorance  and  indifference,  the  fatal  blunders  of  the  past,  cannot 
be  remedied;  we  cannot  recall  the  dead;  but  if  to-day  we  mend  our 
ways  and  heed  the  sanitary  demands  of  the  living,  our  loved  and  lost 
ones  will  not  have  suffered  and  died  in  vain. 


APPENDIX. 


XXI 


INLAND  QUARANTINE. 


By  George  Gillett  Thomas,  M.  D.,  of  Wilmington,  N.  C. 

The  outbreak  of  a  disease  possessed  of  the  power  to  communicate  itself 
from  one  person  to  another,  either  by  direct  contact  or  through  the  medium 
of  its  germs,  or  by  means  of  fomites,  as  it  is  generally  expressed  among 
medical  men,  is  the  reason,  and  a  good  one  if  the  danger  to  life  is  immi¬ 
nent,  for  the  establishing  of  such  barriers  as  will  prevent  the  introduc¬ 
tion  of  such  diseases  into  a  healthy  community.  The  guards  which 
such  barriers  produce  is  a  quarantine.  This  is  maritime  when  it  takes 
into  consideration  the  care  of  vessels,  their  cargoes  and  crews,  coming 
from  ports  known  to  be  infected  with  dangerous  disease.  When  it  opposes 
the  entrance  of  the  disease  by  inland  routes — that  is,  by  railroad  and 
other  avenues  of  reaching  the  towns,  as  the  county  roads,  and  steam¬ 
boats  and  other  crafts  plying  on  water-ways  between  infected  points 
and  healthy  ones — it  is  Inland  Quarantine;  and  it  is  to  the  study  of  this 
portion  of  the  sanitary  officer's  work  that  I  invite  your  attention  for  a 
short  while.  The  organization  and  maintenance  of  an  inland  quaran¬ 
tine  is  generally  a  matter  of  much  thought  and  serious  trouble  to  the 
health  officers  of  communities  everywhere  that  are  threatened  with  an 
invasion  of  a  dangerous  disease.  So  complete  is  the  confidence  of  med¬ 
ical  men  in  the  efficacy  of  vaccination,  and  the  prompt  isolation  and 
treatment  of  persons  and  their  effects  infected  with  small-pox,  that  it 
hardly  appears  necessary  to  include  this  among  the  diseases  that  would 
be  subject  to  quarantine  of  the  character  we  are  studying.  The  same 
may  be  said  of  typhus  fever.  So  that,  ordinarily,  but  two  diseases  are  to 
be  guarded  against  by  quarantine  officials — cholera  and  yellow  fever. 
And  practically  at  present  the  latter  is  the  important  one  to  consider, 
because  of  its  relatively  frequent  appearance  on  the  Southern  Atlantic 
and. Gulf  seaboard  and  the  inland  towns  immediately  in  communication 
with  the  coast  towns  and  cities,  as  well  as  because  of  the  peculiarly 
subtle  poison,  and  its  manifold  ways  of  finding  a  new  point  in  which  it 
may  spread  and  bring  panic  and  death.  Cholera,  it  would  seem  from 
the  experience  of  to-day,  can  be  corraled  in  the  place  where  it  first 
appears,  if  a  strict  cordon  sanitaire  is  preserved,  and  proper  steps  are 
taken  to  destroy  the  fomites,  chiefly  present  in  the  alvine  dejections  of 
the  persons  affected,  and  also  to  cleanse  the  town  and  put  it  in  strictly 
sanitary  condition,  thus  starving  out  the  disease  and  stopping  its  progress. 

It  appertains  as  well  to  the  proper  presentation  of  our  subject  to  say 
that  the  first  duty  of  the  officials  charged  with  the  care  of  the  health  of 
a  community  in  times  of  danger,  and  preparing  for  inland  quarantine, 
is  the  thorough  cleansing  of  the  towns.  It  is  a  fact  that  is  beyond  con- 

3 


XXII 


APPENDIX. 


tradiction  that  it  too  often  requires  the  approach  of  danger,  in  the 
shape  of  mortal  disease,  to  stir  up  the  energies  of  health  officers  to  the 
full  performance  of  their  duty,  and  great  good  is  the  result  that  follows 
in  the  wake  of  a  settling  panic.  As  this  duty  is  one  that  is  constant,  its 
performance  should  need  no  word  of  advice  to  spur  it  up,  nor  should  it 
be  difficult  of  accomplishment,  as  the  means  and  the  measures  should 
be  well  known.  It  is  sad  commentary  on  the  work  of  superintendents 
of  health  and  their  officers  that  it  should  be  necessary  to  say  this  much, 
but  its  truth  should  start  them  into  the  fulfilment  of  the  labors  of  their 
position,  and  the  reminder  be  robbed  of  any  unpleasantness  by  any  ben¬ 
efits  that  may  follow  it.  When  the  barriers  that  an  inland  quarantine 
imposes  are  set  up,  there  is  need  for  careful  consideration  for  all  the 
interests  involved.  Of  course,  the  first  care  of  the  quarantinist  is  for 
the  lives  and  health  of  the  community  under  his  charge,  and  to  this  all 
other  interests  must  yield.  But  this  must  be  so  regulated  as  to  offer  as 
little  embarrassment  to  trade  and  traffic  over  railroads,  water-ways  and 
through  the  country  as  is  compatible  with  securing  the  first  and  main 
object  of  his  office.  He  must  adopt  such  laws  as  will  be  just  and  equi¬ 
table,  and  enforce  them  with  the  severity  of  military  discipline.  The 
hardships  that  will  follow  this  unfailing  application  of  regulations  will 
diminish  as  they  come  to  be  understood  and  appreciated,  and  gross 
errors  can  hardly  happen  when  the  officials  are  governed  by  good  judg¬ 
ment  and  strict  performance  of  duty. 

What,  then,  seem  to  be  some  of  the  most  important  practical  details  of 
a  well  ordered  inland  quarantine  ? 

Let  us  suppose,  or  rather  let  us  say,  that  the  first  essential  is  the  choice 
of  the  persons  to  whom  should  be  committed  the  care  of  the  stations, 
under  the  direction  of  the  superintendents  of  health,  and  the  local 
health  board.  The  latter  are  presumably  informed  of  the  necessities  of 
the  occasion,  or  are  able  to  procure  information  for  the  State  Board  of 
Health,  and  their  fitness  is  not  now  under  discussion.  Happy  the  com¬ 
munity,  if  they  have  been  wisely  chosen  !  But  these  local  authorities 
must  see  that  the  underlings  are  fitted  for  the  duties  assigned  them,  and 
exact  from  them  implicit  obedience  to  instructions,  which,  in  turn,  must 
be  clear  and  easily  understood.  This  class  includes  the  person  or  per¬ 
sons  in  charge  of  the  station  to  be  maintained  near  the  town,  the  sani¬ 
tary  police,  or  detectives,  who  are  to  inspect  the  different  routes  entering 
into  a  town  and  report  the  approach  of  dangerous  persons.  They  should 
have  power  to  stop  these  persons,  or  see  that  they  go  through  without 
communication  with  any  one  in  the  community.  These  men  are  to  be 
selected  for  their  firmness  and  judgment,  and  much  depends  upon  their 
efficient  performance  of  duty. 

I  wish,  before  going  further  into  this  matter,  to  offer  you  a  letter  on 
our  subject  from  Mr.  Henry  Haines,  the  very  intelligent  superintend¬ 
ent  of  the  Plant  system  of  railways  in  Georgia  and  Florida,  which  are 


APPENDIX. 


XXIII 


connected  with  the  West  Indies  by  a  line  of  steamships  owned  and 
controlled  by  Mr.  Plant: 


“Savannah,  Ga.,  January  24,  1889. 

“You  ask  my  views  with  reference  to  quarantine  matters.  I  have 
been  compelled  through  necessity  to  give  the  matter  a  great  deal  of 
attention  during  the  last  year,  and  have  somewhat  definite  ideas  with 
reference  to  it.  These,  however,  I  could  hardly  jot  down  in  this  hasty 
way  to  stand  aggressive  criticism;  but,  firstly  and  foremost,  I  must 
say  that  I  think  it  is  impracticable  to  try  to  fence  infectious  epidemics  out. 

I  think  they  ought  to  be  fenced  in,  beginning  with  the  room  in  which  the 
first  case  appears  and  extending  the  cordon  to  the  house,  to  the  quarter 
of  the  city,  to  the  limits  of  the  city,  etc.,  as  the  circumstances  may 
require.  The  next  point  I  wish  to  make  is  that  I  am  fully  in  favor  of 
establishing  camps  of  detention  for  all  persons  desiring  to  leave  infected 
places.  I  say  this  after  a  careful  observation  of  the  operations  at  Camp 
Perry  this  past  season.  It  is  a  fact  that  not  a  single  case  of  yellow  fever 
appeared  in  Camp  Perry  on  any  person  who  had  been  out  of  Jackson¬ 
ville  over  five  days;  and  this  goes  to  show  that  a  person  five  days  out 
from  an  infected  place,  and  not  taking  any  baggage  that  may  be  the 
means  of  carrying  infection  with  it,  could  enter  into  any  community 
without  endangering  its  health.  I  think  that  a  person  bearing  a  satis¬ 
factory  certificate  of  detention  of  this  kind  ought  to  be  allowed,  not  as 
a  privilege,  but  as  the  right  of  a  citizen  of  the  United  States,  to  enter 
into  any  town  or  community.  I  think  it  a  great  mistake  to  shut  in  the 
population  of  a  large  town  immediately  upon  the  announcement  of  a 
case  of  yellow  fever  in  that  town.  If  the  case  or  ca^es  are  carefully 
guarded  in  the  first  place,  anybody  should  be  permitted  to  enter  and 
leave  the  town  as  they  may  desire,  so  long  as  they  remain  outside  of  the 
cordon  sanitaire. 

“  From  what  I  have  seen  of  baggage  fumigation  I  believe  that  it  is 
perfectly  practicable  to  have  it  done  without  serious  inconvenience  to 
travelers,  provided  it  is  done  at  the  camps  of  detention;  but  once  you 
undertake  to  fence  out  infection  by  quarantine  certificates,  fumigation, 
guards,  espionage,  etc.,  a  condition  of  affairs  is  brought  about  which 
reminds  one  of  civilization  retrograded  to  its  primitive  state  of  anarchy 
and  barbarism.  A  policy  of  this  kind  breeds  suspicion,  fear,  the  lowest 
kind  of  selfishness,  and  does  not  prevent  breeding  infection. 

“  Or  to  sum  up  all  that  I  have  here  stated,  there  is  but  one  way  in 
which  these  measures  that  I  have  referred  to  can  be  cairied  out  success¬ 
fully,  and  that  is  by  an  organized,  experienced  and  disciplined  corps, 
one  for  which  the  formation  at  least  exists  in  the  Marine  Hospital  Ser¬ 
vice.  What  that  service  did  last  summer,  inexperienced  and  without 
precedent  to  go  by,  should  not  be  a  criterion  of  what  it  could  do  another 


XXIV 


APPENDIX. 


season,  profiting  by  the  experience  of  the  past.  The  surgeons  in  that 
service  are  unbiased  by  local  predilections,  they  are  unawed  by  local 
tyranny.  They  have  the  advantage  of  obtaining  information  gathered 
by  headquarters  from  all  over  the  world,  and  as  ilie  purpose  which  they 
are  to  serve  is  the  general  welfare  of  the  United  States,  it  seems  to  me 
right  and  proper  that  the  expense  should  be  borne,  not  by  the  fever- 
stricken  community,  but  from  the  public  treasury.  There  are  many 
details  connected  with  this  general  policy  of  fencing  in  an  epidemic, 
rather  than  fencing  it  out,  which  occur  to  me,  as  they  would  to  you  in 
discussing  the  matter  at  greater  length  than  I  can  afford  here;  so  I  will 
conclude  with  one  more  remark,  and  that  is  that  I  do  not  want  you  to 
allow  yourself  to  suppose  for  one  moment  that  the  yellow  fever  was 
introduced  into  Florida  by  the  Plant  Steamship  Line.  I  have  prepared  an 
official  statement  as  general  manager  of  that  line,  which  will  be  pub¬ 
lished  in  a  few  days,  and  I  ask  that  if  you  doubt  what  I  have  said  that 
you  will  hold  your  opinion  in  suspense  until  you  have  received  a  copy 
of  that  statement.  I  received  an  invitation  a  day  or  two  ago,  from  Dr. 
Jerome  Cochran,  State  Health  Officer  of  Alabama,  to  attend  a  quaran¬ 
tine  conference  at  Montgomery,  on  the  5th  of  March.  I  am  afraid  that 
I  cannot  get  there,  but  it  would  be  an  inducement  for  me  to  do  so  if  I 
could  meet  you  there. 

“  Very  sincerely  yours, 

“H.  S.  HAINES. 

“  Dr.  Thomas  F.  Wood,  Wilmington ,  N.  C.” 

This  is  special  pleading.  For  if  we  are  to  be  governed  by  its  dictates, 
it  is  manifest  that  we  will  have  only  to  sit  still  and  have  others  look 
after  interests  that  most  vitally  concern  us.  However  honest  in  his 
opinions  Mr.  Haines  is,  and  his  known  character  and  position  puts  this 
question  at  rest,  it  is  apparent  that  he  is  warped  by  the  claims  of  the 
great  interests  he  represents. 

Think  of  the  plan:  He  wants  it  ordered  that  diseased  and  panic- 
stricken  towns,  under  the  rule  of  the  officers  of  the  general  government, 
shall  be  alone  responsible  for  the  exit  of  persons  and  their  baggage  from 
the  diseased  midst  into  camps  of  detention,  there  to  be  detained  until 
they  are  declared  safe.  This  declaration  shall  be  final,  and  serve  as  a 
permit  of  entrance  anywhere,  and  an  unquestioned  certificate  that  may 
be  accepted  as  a  guarantee  of  safety  to  places  which  are  liable  to  the 
disease  with  which  these  people  have  suffered,  to  which  they  and  their 
baggage  have  been  exposed.  If  the  restraint  is  self-imposed,  is  it 
supposable  that  weak  humanity  will  regard  it?  Paroles  are  worth 
nothing  when  to  flee  away  under  any  pretence  promises  safety  and 
rest.  We  object  to  his  statements  that  local  inland  quarantine,  which 
fences  out  the  epidemic,  imposes  any  more  hardships  upon  individuals 
than  the  fencing-in  process  which  he  extols.  We  do  not  suppose  any 


APPENDIX. 


XXV 


one  doubts  the  wisdom  of  his  suggestion  as  to  the  treatment  of  the  dis¬ 
ease-infected  room,  house  or  town,  nor  do  we  think  it  even  criticisable. 
But  we  fail  to  see  the  cogency  of  his  statements  which  makes  disinter¬ 
ested  persons  better  superintendents  of  quarantine  than  those  men  whose 
every  thought  is  devoted  to  the  welfare  of  the  community  in  which  they 
lives  and  labors,  and  whose  honesty  of  purpose  is  proven  by  their  self- 
sacrificing  work  in  time  of  dangers.  The  truth  of  Mr.  H.’s  statements 
may  be  good  in  Florida,  but  our  opinion  and  knowledge  of  the  profes¬ 
sion  in  North  Carolina  assures  us  it  is  without  foundation  here.  Mr. 
Haines  deserves  the  unstinted  admiration  of  us  all  for  his  part  enacted 
in  Florida  during  the  pestilence.  Undeterred  by  personal  inconvenience, 
unawed  by  local  tyranny  or  constant  danger,  he  pitched  his  tent  (and 
this  we  say  literally)  in  the  very  front  of  the  battle  that  was  made  in 
Florida  against  the  extension  of  yellow  fever;  and  his  personal  supervi¬ 
sion  of  all  that  was  done,  not  only  for  the  people  of  the  State  where  the 
greater  part  of  his  immense  interests  are  situated,  but  for  the  general 
welfare  of  the  country  threatened  with  a  spread  of  the  epidemic,  make 
all  of  his  observations  worthy  of  earnest  consideration.  But  we  take 
it  to  be  a  safe  rule  of  action  that  if  danger  is  abroad  in  any  form, 
although  confined,  temporarily  at  least,  in  certain  limits,  sound  policy 
will  shut  one’s  own  doors  against  this  danger  that  is  for  the  nonce  inclosed 
somewhere  else.  Self-preservation  is  the  natural  action  which  follows 
the  announcement  that  our  safety  is  threatened,  and  because  some  one 
else  promises  to  keep  it  off,  it  none  the  less  behooves  us  to  look  out  for 
ourselves  and  to  be  ever  active  and  watchful  in  our  own  behalf. 

A  means  of  communication  by  telegraph  or  letter  must  be  estab¬ 
lished  between  the  health  authorities  of  infected  points  or  through  relia¬ 
ble  persons  in  such  localities,  by  which  continuous  and  regular  informa¬ 
tion  may  be  had  concerning  the  progress  of  the  epidemic,  the  movements 
of  persons  and  their  effects  leaving  such  points,  or  articles  of  traffic 
that  are  sent  out,  with  definite  information  concerning  all  such  as  be 
intended  to  reach  and  stop  at  the  guarded  point.  Much  reliance  can  be 
placed  in  ihe  reports  of  the  officers  of  the  general  government  on  all  the 
points,  but  they  are  not  always  specific  enough.  The  approaching  con¬ 
vention  of  the  health  officers,  and  others  interested  in  sanitary  work  in 
the  Southern  States,  and  those  of  the  West  and  Northwest  in  communi¬ 
cation  constantly  with  the  Southern  States,  will  no  doubt  adopt  wise 
means  to  provide  for  the  prompt  supply  of  such  information  as  is 
desired.  This  convention  is  called  at  the  instance  of  the  Secretary  of 
the  Board  of  Health  of  Alabama,  and  its  session  will  be  of  great  interest 
to  all  the  States  summoned  to  the  council.  It  will  deal  chiefly  with  the 
subject  of  inland  quarantine,  and  the  methods  of  its  accomplishment, 
and  I  could  wish  that  it  were  my  duty  to  report  the  result  of  theii  labois 
rather  than  my  own  views. 


XXVI 


APPENDIX. 


It  is  safe  to  say  that  railroad  authorities,  and  the  owners  of  steam¬ 
boats,  will  aid  every  just  effort  that  is  made  to  prevent  the  spread  of 
disease,  from  motives  of  sound  policy  as  well  as  a  desire  to  foster  the 
health  and  thereby  the  business  welfare  of  communities  along  the  main 
lines  or  along  lines  tributary  to  them. 

It  is  with  great  pleasure  that  testimony  is  here  borne  to  the  aid,  will¬ 
ingly  and  intelligently  extended,  which  the  railroad  lines  coming  into 
Wilmington  gave  the  quarantine  officials  of  your  chief  city.  They  not 
only  readily  acquiesced  in  the  inconvenient  measures  which  were  necessa¬ 
rily  adopted  to  provide  safety  for  our  community  during  the  epidemic  of 
yellow  fever  in  the  past  year  in  Florida,  but  stood  ready  to  do  every¬ 
thing  in  their  power  to  further  and  perfect  the  wTork  of  the  officials. 
This  experience  may  not  be  isolated,  but  it  is  none  the  less  worthy  of 
record  and  recollection. 

To  return  to  the  discussion  of  some  of  the  details  of  the  work  before 
us.  A  comity  of  interests  having  established  an  exchange  of  informa¬ 
tion  in  the  possession  of  the  officials  at  different  points  alike  threatened 
by  the  invasion  of  disease,  giving  warning  of  the  movements  of  persons 
and  baggage,  the  quarantine  officer  in  charge  must  be  ready  to  meet  an’ 
emergency  arising  out  of  the  arrival  of  persons  and  their  baggage  from 
an  infected  locality  and  seeking  refuge  in  his  town.  This  will  require  a 
hospital  and  a  house  of  observation.  These  should  be  erected  at  a  point 
sufficiently  removed  from  the  town  to  render  it  impossible  for  commu¬ 
nication  to  be  had  between  persons  detained  and  their  friends  in  the 
community.  Due  regard  should  be  had  in  the  selection  of  a  site  for  its 
healthfulness  and  water  supply,  as  the  care  of  the  quarantined  persons 
must  not  be  so  loose  as  to  engender  sickness  among  them  arising  out  of 
bad  judgment  in  the  choice  of  the  quarantine  station.  As  these  build¬ 
ings  and  the  smaller  and  necessary  out-houses  will  be  for  temporary  use, 
they  can  be  cheaply  built,  and  destroyed  when  the  danger  is  over,  if 
there  has  been  disease  introduced  into  them. 

The  house  of  detention,  or  the  one  set  apart  for  individuals  not  sick, 
but  coming  from  an  infected  point,  we  will  call  the  house  for  observa¬ 
tion,  and  into  it  should  be  put  all  such  persons  as  we  here  indicate,  and 
there  to  be  detained  until  such  time  has  elapsed,  after  exposure  to  the 
disease  prevailing  in  the  town  they  have  left,  for  its  development  and 
appearance.  For  this,  fourteen  days  will  suffice,  counting  from  the  time 
of  their  departure  from  their  homes,  or  exposure  to  material  known  or 
suspected  of  being  infected.  But  simple  detention,  without  disinfection 
of  these  suspects  and  their  baggage,  would  be  folly;  for  the  seeds  of 
disease  might  be  resident  in  these  persons  or  their  baggage,  and  the 
individuals  escape  the  disease,  and  yet  through  the  spread  of  fomites,  as 
germs  of  disease  are  generally  known,  be  the  source  of  an  epidemic  if 
allowed  to  pass  into  a  town  and  come  in  contact  with  its  inhabitants. 
The  period  when  quarantine  consisted  of  detention  only  has  long  been 


APPENDIX, 


XXVII 


past.  It  is  shelved  with  the  idea  which  excited  the  ridicule  of  the  oppo¬ 
nents  of  this  sanitary  barrier,  that  the  old  Spanish  rule  of  forty  days’ 
detention,  to  be  followed  by  dismissal  without  further  precaution,  was 
the  only  indispensable  act  of  the  health  officer.  Suspected  persons 
arriving  at  the  quarantine  station  should  therefore  be  disinfected — first, 
in  their  own  persons,  by  ample  provisions  for  bathing  and  plenty  of  soap, 
care  being  taken  that  such  ablutions  shall  be  efficient  and  thorough, 
including  all  the  body,  and  especially  the  hair  of  the  head  and  the  beard. 
Such  clothing  as  is  worn  at  the  time  of  arrival  must  not  be  again  used 
until  it  has  been  disinfected  along  with  the  baggage,  and  all  clothing  or 
bedding  not  capable  of  prolonged  boiling,  or  of  being  subjected  to  the 
fumes  of  sulphurous  acid,  or  immersion  in  a  solution  of  the  bi-chloride 
of  mercury  of  standard  strength,  not  exceeding  one  part  of  the  subli¬ 
mate  to  three  thousand  parts  of  water,  the  particular  one  of  these  agents 
to  be  selected  by  the  official  in  charge,  should  be  destroyed  by  fire.  The 
walls  of  the  house  occupied  by  the  suspects  should  be  washed  in  a  solu¬ 
tion  of  crystallized  carbolic  acid,  of  a  five  per  cent,  strength,  and  the 
grounds  immediately  around  the  house  and  such  places  as  receive  the 
dejections  from  such  persons  be  frequently  sprinkled  freely  with  the 
same  solution,  care  being  taken  to  guard  the  water  supply  against  con¬ 
tamination  by  this  drug  or  others  in  solution  used  as  disinfectants. 
This  disinfection,  by  washing  in  boiling  water,  fumigating  with  vapors 
of  sulphurous  acid,  or  immersion  into  solution  of  the  mercuric  salt, 
must  be  done  away  from  the  living  house  of  these  people,  and  will 
therefore  require  a  small  chamber,  fitted  for  the  purpose,  especially  for 
the  confinement  of  the  sulphur  fumes,  if  that  agent  is  the  one  adopted. 
Washing  or  boiling,  or  both,  could  be  done  out  of  doors;  but  the  articles 
to  be  treated  must  be  taken  from  the  house  of  observation,  or  the  recep¬ 
tacles,  as  trunks  or  boxes,  containing  them,  and  placed  in  boiling  water 
to  be  carried  to  the  place  where  the  final  disinfection  shall  be  practiced. 
The  house  set  apart  as  a  hospital  proper  should  be  at  least  three  hun¬ 
dred  feet  away  from  the  place  where  the  well  people  are,  and  it  is  need¬ 
less  to  discuss  its  arrangement,  as  that  will  follow  the  necessities  of  the 
occasions  for  its  use.  But  if  persons  arrive  at  the  station  actually  dis¬ 
eased,  or  be  attacked  after  arrival,  they  must  be  immediately  and  com¬ 
pletely  separated  from  the  well,  and  communication  between  them  01 
their  attendants  be  absolutely  interdicted.  This  rule  should  be  inviola¬ 
ble.  Should  such  patients  die,  their  bodies  should  be  immediately  wrapped 
in  cloths  wrung  out  of  the  sublimate  solution  triple  the  strength 
already  mentioned,  and  interment  should  follow  as  soon  as  possible.  If 
recovery  should  follow  the  treatment,  then  they  should  stand  on  the 
same  footing  as  suspected  persons,  and  be  disinfected  by  hot  bates,  v  ith 
plenty  of  soap,  before  mingling  with  the  well.  Each  community ,  thi  ougli 
its  officials,  must  settle  the  question  of  providing  for  the  sustenance  of 
these  persons  under  detention;  but  it  seems  a  fair  nile,  that  lefugees 


XXVIII 


APPENDIX. 


from  an  epidemic,  seeking  entrance  into  a  healthy  community,  should 
be  compelled  to  provide  for  themselves  through  an  authorized  commis¬ 
sary,  unless  their  condition  is  such  as  would  clearly  indicate  their  claim 
for  charity.  So  much  is  needed  for  the  proper  establishment  of  the 
station. 

Persons  from  infected  points  passing  through  the  town  under  quaran¬ 
tine  should,  if  in  railroad  cars,  be  locked  in  during  the  transit  through 
the  town,  and  no  outside  person  should  be  allowed  to  have  communica¬ 
tion  with  them  or  to  handle  their  clothing,  except  such  persons  as  are 
necessary  for  the  railway  service.  Due  notice  should  be  served  upon  all 
persons  that  violation  of  this  rule  will  subject  them  to  isolation  at  the 
quarantine  station,  and  passengers  should  be  informed  by  the  sanitary 
police,  or  by  circulars  distributed  among  them,  that  the  same  punish¬ 
ment  will  follow  their  leaving  the  coaches  and  attempting  to  reach  the 
guarded  town  by  other  avenues. 

The  travel  by  water  is  more  difficult  of  management,  but  the  same 
supervision  and  care,  altered  to  the  changed  circumstances,  will  serve 
in  this  case  as  well  as  in  that  of  railway  travel.  Provision  should  be 
made  looking  to  the  disinfection  of  the  coaches  occupied  in  transit  by 
these  infected  persons  and  their  dangerous  baggage.  This  is  a  matter 
easy  of  arrangement  with  the  railroad  authorities  by  intelligent  and 
liberal  health  boards. 

It  will  readily  appear  to  those  of  you  acquainted  with  the  character  of 
river  travel,  that  there  is  constant  need  of  the  sharp  eye  of  the  sanitary 
officer.  The  quarters  of  the  crew  and  the  points  about  a  steamboat 
where  dirt  of  the  worst  kind  will  accumulate,  the  bilge,  form  excellent 
breeding  places  fora  disease,  if  the  germs  are  once  introduced.  For  the 
time,  at  least,  of  the  quarantine,  they  should  be  known  to  be  clean  and 
well  aired,  and  the  bilge  should  be  very  frequently  discharged,  and 
means  adopted  for  cleansing  and  disinfecting  all  points  reached  by  it. 

Should  there  a  colonization  of  refugees  from  an  epidemic  be  allowed 
in  any  part  of  the  State,  where,  on  account  of  climate  and  altitude  above 
the  sea  level,  no  danger  is  feared  of  a  local  outbreak  of  the  disease,  the 
health  officers  general  of  the  State  should  protect  other  localities  from 
visits  of  these  refugees,  except  under  the  same  restrictions  as  apply  to 
persons  directly  from  a  diseased  town.  Such  oversight  should  be  exer¬ 
cised  that  the  movements  of  these  people  should  be  known  from  day  to 
day,  and  towns  having  established  quarantines  notified  of  their  depart¬ 
ure  from  the  community  which  has  received  the  colony.  It  would  be 
well  to  demand  that  these  persons  should  possess  themselves  of  a  permit 
from  the  local  health  officer,  with  their  destination  set  out  in  the 
permit,  and  this  should  be  declared  under  oath. 

The  experience  of  the  past  summer  in  allowing  the  entrance  of  per¬ 
sons  from  Florida  into  one  of  our  mountain  towns  was  anything  but 
pleasant  to  the  cities  on  the  seaboard  in  more  or  less  communication 


APPENDIX. 


XXIX 


with  it.  In  the  city  of  Wilmington,  within  seventy-two  hours  after  the 
anival  of  the  refugee  train  in  Hendersonville,  there  appeared  three  per¬ 
sons,  all  of  them  of  the  refugee  colony,  hoping  to  slip  into  the  city  and 
get  passage  by  steamer  to  New  \ork,  that  being  a  cheaper  route  than 
by  rail,  but  which  would  have  forced  them  to  remain  within  the  cor- 
poiate  limits,  if  they  had  reached  here  undetected,  for  four  or  five  davs, 
with  their  baggage.  Fortunately,  they  were  found  out  and  turned  back 
to  seek  another  route  to  the  North.  It  is  very  charming  to  open  one’s 
door  to  the  needy  and  the  frightened  person,  flying  from  disease,  and, 
may  be,  death;  but  it  is  false  charity  to  accept  such  strangers  as  guests, 
if  they  will  bring  disease  to  one’s  neighbor  less  advantageously  situated 
than  the  host  whose  hospitality  seems  so  Christian-like. 

The  disposition  of  freight  arriving  from  infected  points  is  much  more 
difficult  of  management  than  persons  or  their  effects.  To  interdict  the 
reception  of  such  materials  as  would  be  classed  as  freight  would  often 
clog  the  commercial  interests  of  a  town,  and  a  wise  discretion  is  needed 
for  the  proper  care  of  such  cases.  Perishable  articles,  as  vegetables  or 
fruits,  should  be  laid  under  embargo,  as  it  is  generally  the  case  that  there 
is  more  or  less  of  such  matter  in  a  state  of  decay,  and  this  condition 
favors  the  increase  of  the  seeds  of  disease,  if  they  had  found  a  lodgment 
in  the  crates  before  their  shipment.  Woolen  goods  of  all  sorts,  coal, 
hides,  and  wooden  packages  of  all  freight  that  contain  materials  likely 
to  be  damp,  should  have  special  inspection  and  attention.  The  stern 
necessity  of  the  preservation  of  the  public  health  at  the  expense  of  all 
other  objects,  may  make  it  expedient  for  the  quarantine  official  to  destroy 
with  fire  material  that  reaches  his  town,  when  such  destruction  may  work 
a  hardship  upon  some  persons.  As  the  life  and  health  of  every  inhabi¬ 
tant  of  a  community  has  a  money  value,  it  is  not  saying  too  much  to 
claim  that  it  will  be  a  burden  that  tax-payers  ought  willingly  to  assume, 
which  will  reimburse  the  losers  for  the  material  destroyed  for  the  gen¬ 
eral  weal. 

Fortunately,  there  is  but  little  to  be  feared  from  such  sources  of  danger 
in  yellow  fever  epidemics  south  of  us;  but  if  any  one  of  the  coast  towns 
of  the  State  should  unhappily  be  stricken  with  the  scourge,  then  the 
inland  towns  would  have  ample  room  for  the  application  of  these  rules. 

If  it  should  be  cholera  or  small-pox  that  is  guarded  against,  the  danger 
is  alike  threatening  everywhere,  and  careful  inspection  is  called  for  in 
this  department  of  quarantine.  There  is  a  safe  rule  governing  the  man¬ 
agement  of  this  particular  class  of  dangerous  articles,  which  I  can  illus¬ 
trate  by  the  regulations  of  the  quarantine  at  the  mouth  of  the  Cape  Fear 
river:  Every  vessel  from  a  suspected  port  must  come  to  the  station  for 
inspection,  and  disinfection  and  detention  are  ordered  in  each  case  upon 
the  quarantine  physician’s  judgment,  and  not  by  fixed  rules  ;  that  is. 
while  it  is  safe  to  stop  for  examination  all  articles  from  suspicious  local- 


XXX 


APPENDIX. 


ities,  it  is  not  sound  policy  to  permanently  detain  or  destroy  them  because 
of  their  having  come  from  such  places. 

The  general  government  has  amply  provided  for  the  care  of  the  mails 
in  times  of  danger,  and  though  it  is  not  proven  that  yellow  fever  has 
ever  been  transmitted  through  the  mails,  their  disinfection  serves  to 
allay  uneasiness,  even  if  unnecessary. 

The  fact  that  yellow  fever  has  been  carried  from  Savannah,  Ga.,  to 
Chattanooga,  Tenn.,  from  Florida  to  Decatur,  Ala.,  and  to  two  other 
towns  in  Mississippi;  that  it  spread  several  years  ago  with  alarming 
rapidity  up  the  Mississippi  river,  reaching  out  into  towns  far  removed 
from  the  river,  and  which  had  previously  escaped  the  scourge — all  these 
and  many  like  well  known  facts  are  important  to  remember,  and  the 
outbreak  of  the  fever  in  our  own  State,  or  at  points  north  or  south  of 
us,  will  require  the  establishment  of  inland  quarantine  at  all  places  in 
North  Carolina  having  a  lower  altitude  than  800  to  1,000  feet  above  sea 
level.  Previous  immunity  may  be  plead  to  offset  this  remark.  But  if 
wise  precautions  are  not  taken  in  times  of  danger,  neglect,  based  upon 
escape  in  the  past,  will,  at  some  time,  work  a  disaster  that  will  be  more 
costly  in  lives  and  treasure  than  quarantine  can  ever  spend  in  money. 

The  expenditure  of  money,  the  untiring  vigilance  of  health  officers, 
the  cleanliness  of  towns,  and  over  all  the  watchful  eye  of  the  State 
Board  of  Health,  can  prevent  disease  from  finding  a  foothold;  but  no 
one,  or  all  of  them,  can  secure  the  ousting  of  the  enemy,  except  with 
great  loss,  if  once  his  entrance  is  admitted. 

The  powers  of  the  State  Board  of  Health  should  be  mandatory,  and 
not  simply  advisory,  as  they  are  now.  To  them  local  authorities  can  ap¬ 
peal  for  help  and  advice  when  needed;  information  will  follow'  the  ask¬ 
ing;  means  and  measures  for  combatting  danger  will  be  furnished  them 
under  wise  and  liberal  law's;  and,  in  sudden  emergencies,  reliance  can 
be  placed  upon  the  personal  supervision  of  the  general  officers  of  the 
State  Sanitary  Police,  bringing  wuth  them  experience  and  comfort, 
where,  without  them,  dismay  and  panic,  and  probably  disaster,  might 
follow'  their  unaided  efforts. 


APPENDIX. 


XXXI 


MARITIME  QUARANTINE. 


By  W.  G.  Curtis,  M.  D.,  Quarantine  Physician  of  the  Port  of 

Wilmington,  N.  C. 


Few  people,  either  in  the  profession  of  medicine  or  out  of  it,  have 
given  much  attention  to  the  subject  of  maritime  quarantine.  By  those 
living  afar  from  the  highways  of  commerce,  where,  perhaps,  only  the 
balsamic  odor  of  the  pines  and  the  sighing  and  rustling  of  winds  among 
their  foliage  attract  the  senses,  it  does  not  seem  so  practical  a  matter 
as  to  those  living  near  the  ocean,  where  tides  are  ebbing  and  flowing, 
and  ships  sailing  to  and  fro,  bearing  strange  peoples  and  cargoes  from 
unknown  countries.  But  the  rivulets,  beginning  in  the  highlands  of 
the  interior,  all  run  towards  this  mighty  ocean,  broadening  as  they  go. 
The  great  lines  of  railroads,  converging  always  towards  that  point 
where  there  is  a  seaport,  run  up  the  valleys,  and  there  is  a  continual 
circulation  from  the  mountains  to  the  ocean,  from  the  ocean  to  the 
mountains,  interchanging  commodities  and  ideas,  and,  sometimes, 
unhappily,  diseases. 

From  land  to  land,  in  both  hemispheres,  stretches  this  vast  and  bound¬ 
less  ocean.  Here  and  there  upon  its  shores  lies  a  city,  built  by  the  inex¬ 
orable  demands  of  commerce — in  one  place  clean  and  beautiful  to  look 
at,  in  another  festering  with  poverty  and  disease. 

But  with  them  all,  trade  and  commercial  relations  with  other  cities  is 
the  ruling  idea,  without  which  no  city  can  have  an  existence  ;  and,  as 
if  placed  by  Providence  to  foster  and  make  easy  commercial  dealings, 
here  is  this  mighty  ocean  ready  to  bear  upon  its  bosom  the  ships  of  the 
world,  with  whatever  freight  may  be  offered  for  transportation. 

Hence,  we  have  rags  from  Calcutta,  from  Egypt  and  Italy,  intermixed 
more  or  less  with  cholera  germs  ;  coffee  from  Rio  de  Janeiro,  in  infected 
bags';  sugar,  taken  from  infected  warehouses  and  wnarves  in  Havana; 
emigrants  from  Italy,  carrying  cholera  and  small- pox;  and  vessels  carry¬ 
ing  these  cargoes  go  to  New  York,  Philadelphia,  Wilmington,  Charleston, 
and  all  ports  of  the  Atlantic  and  Gulf  coast,  and  so  on  o\er  the  woild, 
trading  and  poisoning,  civilizing  and  infecting,  until  one  is  fain  to  wish 
he  did  not  live  in  a  world  which  began  business  in  the  Garden  of  Eden, 
by  trading  with  the  Devil,  and  getting  sold. 

All  nations  and  peoples,  however,  have  objected  to  this  mixtuie  of 
disease  germs  with  goods  and  merchandise,  and  have  in  vaiious  ways 
protested  against  it.  For  it  is  so  obviously  the  duty  of  e\  eiy  gov ei  nment 
to  protect  the  lives,  liberties  and  property  of  its  citizens,  that  no  doubt 
has  ever  existed  of  the  propriety  of  enacting  sanitaiy  laws,  and  of 
making  them  efficient,  so  far  as  there  existed  scientific  knowledge  as  a 
basis  for  such  laws;  and  so  great  has  been  the  necessity  for  protection  at 


XXXII 


APPENDIX. 


times,  that  governments  have  passed  laws  having  no  basis  but  supersti¬ 
tion,  or  the  arbitrary  will  of  the  ruler.  In  the  absence  of  law  the  pop¬ 
ulace  have  often  taken  matters  into  their  own  hands,  and  there  has  been 
rioting  and  outrages  horrible  to  contemplate.  The  subject  has  always 
been,  and  is,  a  difficult  one.  What  was  the  source  of  infection  ?  How 
did  it  travel  and  propagate  itself  ?  If  a  person  was  exposed,  how  long 
was  the  period  of  incubation,  and  when  might  he  consider  himself,  and 
be  considered  safe  ?  How  could  the  infecting  germ  or  element,  whatever 
it  might  be,  be  destroyed  ?  There  must  be  various  kinds  of  infection, 
for  what  would  produce  cholera  would  not  produce  yellow  fever  or  small¬ 
pox.  Now  what  would  be  the  most  powerful  disinfectant  for  each 
variety,  or  would  the  same  one  answer  for  all  kinds  of  infection  ?  Our 
forefathers  found  it  quite  impossible  to  answer  these  questions,  but  they 
did  not  stop  fighting,  and  did  the  best  they  could.  And  sometimes,  in 
their  blind  groping,  they  discovered  something  of  wonderful  value, 
which  has  lasted  until  our  day,  and  which,  it  is  to  be  hoped,  will  last 
during  all  coming  time.  Edward  Jenner  discovered  vaccination  as  a 
protection  against  small  pox,  for  which  no  honor  that  could  be  bestowed 
upon  his  name  would  be  too  great. 

Now,  in  our  day,  we  are  still  groping,  and  we  think  that  perhaps  we 
have  got  results  of  importance.  We  have  got  it  down  fine  on  germs. 
We  have  spirilli,  and  baccilli,  and  bacteria,  each  producing  its  own  form 
of  disease.  We  have  captured  the  rascals  and  are  trying  to  find  out  their 
sensations  when  put  into  the  various  kinds  of  torture  chambers  we  have 
invented  for  their  entertainment.  We  are  boiling  them  with  moist  heat 
and  baking  them  with  dry  heat;  we  are  feeding  them  on  bi-chloride  of 
mercury,  and  generally  doing  our  best  to  make  them  look  sick,  with,  as 
I  said  before,  results  of  importance. 

The  discovery  of  micro-organism  concerned  in  the  production  of  infec¬ 
tious  disease,  of  course  led  naturally  to  experiments  for  their  destruc¬ 
tion,  and  to  the  application  of  the  discoveries  made  to  the  holds  of  ves¬ 
sels,  and  to  articles  of  cargo  and  clothing  containing  germs.  At  the 
quarantine  station  for  the  port  of  New  Orleans  the  methods  for  the 
destruction  of  disease  germs  and  consequent  complete  disinfection  of 
vessels  has  been  practiced  with  great  carefulness  for  several  years,  with 
the  result  of  apparently  giving  complete  protection  to,  not  only  New 
Orleans, -but  the  whole  Mississippi  valley.  At  any  rate,  no  case  of  yel¬ 
low  fever  has  appeared  upon  any  vessel  treated  by  the  methods  in  use  at 
that  port. 

Formerly,  and  not  so  very  long  ago  either,  the  form  of  protest  was  so 
crude  and  inefficient  that  to  us  it  seems  that  the  remedy  was  worse  than 
the  disease. 

Quarantine  means  detention  for  forty  days.  This  appears  to  have  been 
in  many  places  an  iron-clad  rule,  and  it  does  not  require  a  very  vivid 
imagination  to  realize  the  horrors  it  entailed  upon  defenceless  human 


APPENDIX. 


XXXIII 


beings,  shut  up  in  the  narrow  limits  of  an  infected  ship.  In  later 
days  the  period  of  detention  has  been  varied,  and  the  limit  of  variation 
has  been  so  great  in  different  places  as  to  lead  one  to  the  opinion  that  no 
definite  rule  could  be  established,  but  that  the  period  of  detention  was 
purely  experimental  and  empirical. 

The  fact  is,  that  detention  alone,  when  applied  to  an  infected  ship,  is 
making  a  bad  matter  a  great  deal  worse.  All  that  is  done  should  be 
done  with  the  utmost  practicable  celerity.  To  illustrate  this  idea,  let  us 
consider  the  rapidity  with  which  germs  increase  in  number.  A  solution, 
absolutely  freed  from  all  germs,  and  showing  no  life  under  the  micro¬ 
scope,  will,  soon  after  being  exposed  to  the  air,  teem  with  life.  The  hay 
baccillus  has  been  observed  to  double  itself  every  twenty  minutes,  which, 
in  twenty-four  hours,  would  make  numbers  so  great  as  to  be  far  beyond 
human  conception. 

Sewage  contains  75,000,000  germs  to.  the  quart  when  fresh,  but  when 
stagnant  and  putrefying  would  contain  one  hundred  times  that  number. 
The  bacteria  of  yellow  fever  is  probably  as  prolific  as  any  of  the  species, 
and  from  one  centre  will  develop  enough  offspring  to  infect  a  city.  So 
that  the  sooner  we  can  get  at  the  source  of  danger  and  destroy  it,  so 
much  the  better. 

Thus  the  sick  and  the  well  should  be  at  once  separated— the  sick  for 
treatment,  the  well  for  observation— and  both  should  be  taken  from  the 
ship  and  placed  in  quarters  provided  by  the  State.  Then,  and  only  then, 
can  the  ship  be  thoroughly  disinfected,  and  disease  germs  destroyed,  so 
that  her  voyage  can  be  safely  completed— not  only  safely  for  herseff, 
but  safely  for  the  public. 

There  must  be  some  risk,  for  we  have  not  arrived  at  perfection  in  any¬ 
thing, but  the  risk  must  be  reduced  to  a  minimum,  especially  for  the  public. 
We  therefore  set  aside  the  principle  of  detention  for  any  particular  number 
of  days,  as  too  purely  empirical  for  a  profession  which  is  striving  to  get 
a  little  nearer  exactness  than  was  thought  to  be  possible  in  former  times. 
A  vessel  coming  at  quarantine,  therefore,  should  be  treated  purely  upon 
its  merits,  and  without  regard  to  any  other  vessel.  She  should  be  care¬ 
fully  inspected,  and  all  persons  on  board  examined,  and  the  truth  of  all 
papers  verified,  so  far  as  they  certify  to  the  sanitaiy  condition  of  the 
ship.  If  her  record  is  satisfactory  in  all  respects,  the  vessel  should  be 
allowed  to  proceed  on  her  voyage  without  further  detention.  But  on 
the  contrary,  a  record  involving  probable  infection  being  discovered,  01 
a  certainty  of  it,  from  the  presence  of  actual  disease  of  an  infectious 
nature  on  board,  our  responsibility  becomes  grave  indeed,  and  we  ha\e 
to  proceed  with  the  utmost  caution.  Many  interests  aie  to  be  consideied, 

and  all  of  them  important  interests. 

First,  the  safety  of  the  public,  wdiich  is,  of  course,  greater  than  all 
others;  second,  the  safety  of  those  on  board,  who  must  be  divided  into 
two  classes,  the  sick  and  the  well;  third,  the  rights  and  interests  of  the 
owners;  and  lastly,  the  commercial  interests  of  the  port  or  city.  The 


XXXIV 


APPENDIX. 


vessel  must  be  treated  so  that  no  germs  of  disease  escape  to  adjacent 
lands,  or  to  residents  thereon;  and  the  best  manner  of  doing  this,  is  to 
proceed  without  delay  to  our  task,  which  is  by  no  means  easy.  We  take 
all  the  sick  out  of  the  ship,  and  place  them  in  a  hospital  for  treatment. 
This  hospital  should  be  as  far  from  other  dwellings  as  is  practicable, 
and  should  be  provided  with  competent  nurses.  Then  the  well  who 
have  been  exposed  to  infection  should  be  taken  to  another  place  apart 
from  the  sick,  where  their  clothing  can  be  disinfected  and  themselves 
be  under  observation,  until  a  certain  period  from  the  date  of  the  last 
case,  which  period  has  been  ascertained  to  be  beyond  the  limit  of  danger. 
These  things  being  done,  we  proceed  to  discharge  all  ballast  or  cargo  of 
every  kind,  so  that  every  part  of  the  ship  can  be  got  at  and  exposed  to 
such  processes  of  disinfection  as  we  are  able  to  command.  After  this  is 
finished,  which  will  occupy  several  days,  it  is  probable  that  the  period 
of  incubation  will  have  passed,  and  that  we  can  send  the  well  on  board 
again,  and  permit  the  ship  to  proceed  on  her  voyage  without  danger  to 
anybody.  By  this  method,  we  have  done  nothing  which  any  reasona¬ 
ble  human  being  could  complain  of,  and  we  have  protected  our  people. 

And  this  is  the  quarantine  of  modern  times,  perfected  by  experience, 
rid  of  superstition,  and  without  any  of  the  horrors  of  ancient  times. 
This  is  what  every  city  that  depends  on  commerce  for  its  growth  and 
prosperity  must  have,  if  it  expects  to  keep  in  the  foremost  rank  or  to 
sustain  itself  in  the  fierce  competition  for  wealth  and  honors. 

And  why  should  not  every  city  have  such  a  quarantine  establishment? 
All  citizens  who  do  business  in  cities,  all  persons  who  visit  cities  either 
for  pleasure  or  for  purposes  of  trade — the  wealthy  who  own  stock  in 
banks,  railroads  or  manufactories,  and  the  poor  who  go  thither  for  em¬ 
ployment.  should  insist  upon  it  that  the  ways  and  means  for  maintain¬ 
ing  the  public  health  should  be  kept  up  to  the  highest  standard.  Public 
opinion  on  these  points  ought  to  be  so  strong  that  our  legislators  can 
have  no  doubt  as  to  what  they  ought  to  do.  The  cost  is  nothing.  The 
expense  cannot  be  urged  as  a  reason  for  neglecting  such  important  inter¬ 
ests.  A  few  cents  from  each  person  is  all  that  is  necessary,  and  this 
taken  in  such  a  way  that  nobody  will  ever  know  they  have  paid  it. 

How  utterly  insignificant  appears  the  small  expenditure  required, 
when  compared  with  the  immense  benefits  to  be  gained!  Is  there  any 
one  bold  enough  to  dispute  the  proposition,  that  no  worthier  object  can 
occupy  the  human  mind  than  that  of  preventing  the  occurrence  and 
spread  of  such  diseases  as  cholera,  yellow  fever,  small  pox  and  plague  ? 
And  that  it  is  possible  to  root  out  these  diseases  from  the  face  of  the  earth 
is,  I  think,  sufficiently  demonstrated.  I  say  it  is  possible,  but  I  fear 
this  happy  consummation  will  not  be  reached  in  our  day. 

North  Carolina  is  happily  situated,  if  the  experiment  is  to  be  tried, 
with  the  object  of  publishing  to  the  world  that,  within  her  broad  limits, 


APPENDIX. 


XXXV 


no  case  of  either  of  those  infectious  diseases  can  find  a  foothold.  The 
point  of  greatest  danger  to  the  people  of  North  Carolina  is  the  Cape 
Fear  river.  Through  this  avenue  a  vast  commerce  is  transacted,  bring¬ 
ing  the  ships  of  all  nations  to  our  very  doors.  We  are  near  the  West 
Indies,  and  many  of  her  ports  are  constantly  dangerous.  We  must  have 
coffee  and  sugar,  molasses  and  rum  :  we  want  oranges,  bananas,  cocoa- 
nuts,  and  spices  of  all  kinds,  and  we  want  to  sell  the  productions  of  our 
own  State  in  exchange  for  them.  Hence,  we  have  to  inspect  every  ship, 
and  subject  each  one  to  the  rules  and  regulations  of  a  rigid  quarantine. 
If  we  neglect  this,  pestilence  will  as  surely  come  in  as  the  sun  shines.  We 
all  know  what  that  means  ;  we  have  seen  it  before  our  eyes  during  the 
whole  of  the  last  summer,  desolating  homes,  destroying,  by  its  fell 
touch,  the  noblest  and  the  bravest  of  our  people,  ruining  private  busi¬ 
ness,  and  causing  fortunes  to  melt  away  like  dew  before  the  morning 
sun,  driving  defenceless  people— women,  children,  and  the  poor— out  of 
their  homes,  to  wander  among  strangers,  to  be  shunned  and  pointed  at 
as  unclean,  to  be  arrested,  and  perhaps  imprisoned,  by  shot-gun  officials. 
We  know  all  these  things,  and  what  they  cost.  It  is  not  necessary  to 
go  over  all  the  sickening  details;  but  in  a  paper  whose  object  it  is  to 
induce  the  good  citizens  of  North  Carolina  to  make  preparations  to  avert 
impending  evil,  it  is  best  thus  briefly  to  advert  to  them. 

North  Carolina  has  upon  her  statute  books  a  good  and  efficient  quar¬ 
antine  law.  It  has  been  tested  and  found  to  have  ample  powers,  and  its 
working  is  smooth  and  satisfactory,  and  but  little  change  is  asked  for. 
The  weak  point  is,  that  we  have  no  hospital  or  building  for  those  placed 
under  observation,  and  we  have  no  wharves  where  ships  can  discharge 
ballast  and  cargo  previous  to  disinfection.  The  law  provides  for  these, 
and  a  bill  has  been  introduced  into  the  present  Legislature  asking  for  an 
appropriation.  We  hope  and  believe  that  a  wise  legislative  body  will 
not  hesitate  in  voting  the  appropriation  asked  for.  If  they  do,  the 
Quarantine  Board  will  be  well  equipped,  and  will  be  able  to  do  all  that 
is  possible,  in  any  way,  at  least  equal  to  that  of  any  other  State. 

In  a  purely  commercial  poini  of  view,  1  tnink  the  question  one  of  the 
utmost  importance,  and  worthy  of  serious  attention  by  the  Legislature. 

A  remarkable  change  has  taken  place  at  the  eo  trance  to  the  Cape  Fear 
river.  The  depth  of  water  on  the  bar  lias  been  so  increased  that  vessels 
drawing  nearly  twenty  feet  of  water  can  ent*  r  the  harbor  at  Southport, 
and  the  U.  S.  Government  is  endeavoring  to  increase  the  depth  in  the 
channel  of  the  river  as  far  up  as  Wilmington.  The  attention  of  capital¬ 
ists  has  been  drawn  to  the  yreat  value  of  this  harbor,  and  several  lines 
of  railroads  are  projected  or  in  process  of  construction,  the  shorter 
distance  from  the  citie>  of  the  West  to  ports  on  the  Cape  Fear,  n  eaning 
cheaper  transportation  and  increased  value  for  the  productions  of  the 
interior. 


XXXVI 


APPENDIX. 


In  this  view,  therefore,  the  citizens  of  the  State  and  their  representa¬ 
tives  here  should  wish  to  make  of  Wilmington  a  city  with  a  clean  record 
for  healthfulness — a  city  fortified  in  all  her  approaches  by  the  most  im¬ 
proved  sanitary  devices — a  city  beyond  reproach,  where,  at  any  season 
of  the  year,  they  may  safely  go  with  their  wives  and  children  on  business 
or  pleasure.  Laws  passed  with  those  ends  in  view  will  be  approved  by 
the  people  everywhere. 

The  time  will  surely  com  1  when  cleanliness  will  really  be  next  to  god¬ 
liness — when  the  authorities  of  cities  and  towns  will  be  held  to  a  strict 
account  for  neglect  of  sanitary  matters. 

So  far  as  North  Carolina  is  concerned,  the  matter  may  be  summarized 
in  a  few  words:  Impose  an  impassable  bnrr  er  to  the  entrance  of  cholera 
and  yellow  fever  by  a  perfect  quarantine  establishment,  vaccinate  your 
children  and  teach  them  its  value,  so  that  in  turn  they  will  not  neglect 
their  own;  keep  your  cities  clean  and  well  drained;  let  the  sun  shine 
into  your  houses  every  day,  if  possible,  and  peace  will  dwell  within  your 
walls  and  plenteousness  within  your  palaces. 


APPENDIX. 


XXXVII 


THE  NECESSITY  OF  STATE  INTERVENTION  TO  PREVENT  A I  'UL- 

TERATION  OF  FOOD  AND  DRUGS. 


By  Prof.  F.  P.  Venable,  Ph.  D.,  F.  C.  S.,  Chapel  Hill. 


The  pui  it\  of  our  foods  and  drugs  should  be  a  matter  of  paramount 
importance  to  us.  It  is  a  matter  affecting  both  health  and  pocket.  The 
sanitary  officers  who  look  after  the  air  we  breathe  and  the  water  we 
drink  ought  certainly  to  inspect  our  solid  food  as  well.  Danger  does 
not  lurk  in  sewer-gas  or  in  the  miasm  of  the  marsh  only,  nor  in  contami¬ 
nated  wells  and  foul  reservoirs  alone.  We  might  avoid  all  of  these 
sources  of  disease  and  yet  fall  victims  to  poisons  in  our  foods  or  impure 
medicines. 

And  yet  it  is  very  difficult  to  effectually  arouse  interest  in  this  subject. 
An  occasional  newspaper  article  filled  with  sensational  exaggerations 
gains  the  public  attention  for  a  bri-  f  while,  and  then  barter  and  sale  go 
on  as  before,  and  the  same  luck  that  attends  the  tottering  footsteps  of 
the  baby  and  the  staggering  drunkard  is  looked  to  to  befriend  us  and 
help  us  escape  the  greed  and  criminality  of  our  fellows. 

What  this  indifference  springs  from  I  cannot  tell.  Perhaps  for  most 
of  our  citizens  the  coffee  or  tea  is  so  poorly  prepared  that  the  genuine 
article  would  be  unrecognizable;  or  the  fat  and  s  da  and  bad  cooking 
are  productive  of  such  indigestion  as  to  completely  mask  the  effects  of 
any  mildly  poisonous  adulterant.  The  majority  of  people  who  think 
upon  the  subject  at  all  may  regard  adulteration  as  beyond  their  power 
to  check  or  remedy,  and  throw  themselves  upon  the  mercy  of  the  more 
honest  dealers. 

But  whether  we  choose  to  stop  and  think  it  over  or  not,  the  purity  of 
our  food  and  its  wholesomeness  is  an  exceedingly  important  subject; 
whether  we  prepare  it  right  or  not,  is  another  matter  also  very  impor¬ 
tant,  and  the  remedy  for  which  is  within  the  power  of  each  individual. 
The  remedy  for  the  first  must  be  sought  for  collectively. 

Sensationalists  in  books  and  newspapers  have  unquestionably  been 
guilty  of  exaggeration  as  to  the  frequency  and  the  dreadful  nature  of 
adulteration.  The  matter  is  bad  enough  without  exaggeration.  Let  us 
inquire  into  the  extent  to  which  adulteration  of  articles  of  food  is  prac¬ 
ticed,  using  only  entirely  reliable  data. 

The  National  Board  of  Health  some  years  ago  appointed  a  committee 
to  draw  up  a  report  as  to  the  extent  to  which  the  adulteration  of  food 
was  practiced  in  the  United  States,  but  no  report  has  ever  been  pub¬ 
lished.  Of  course  the  work  of  such  a  committee  must  of  necessity  have 
been  very  incomplete,  yet  it  would  have  been  of  great  value,  and  it  is 
to  be  hoped  that  some  department  of  the  Government  will  carry  out. 

4 


XXXVIII 


APPENDIX. 


such  an  investigation.  In  the  place  of  general  and  full  statistics  I  give 
some  compiled  from  various  boards  of  health  and  other  authorities  by 
Battershall,  which  will  enable  us  to  form  a  judgment  as  to  the  extent  of 
adulteration.  Over  45  per  cent,  of  the  ground  coffees  examined  were 
found  to  be  adulterated :  50  per  cent,  of  the  baking  powders  used  in  the 
United  States  contain  injurious  substances;  50  percent,  of  the  honey 
examined  by  the  Massachusetts  Board  of  Health  in  1885  was  adulter¬ 
ated;  so,  too,  was  58  per  cent,  of  the  cheaper  confectionery ;  over  70  per 
cent,  of  the  samples  of  vinegar  examined  in  1884  fell  below  the  stand¬ 
ard;  71  per  cent,  of  the  olive  oil  was  spurious;  60  per  cent,  of  the  mus¬ 
tard,  61  per  cent,  of  the  pepper,  ami  45.66  per  cent,  of  the  different 
spices  were  adulterated.  A  wTell  enforced  law  of  the  United  States 
Government  protects  us  from  fraud  in  imported  teas.  All  of  this  should 
show  us  conclusively  that  impure,  unwholesome  food  is  sold  very  com¬ 
monly,  and  some  protective  measures  must  be  adopted  against  such 
adulterations. 

Feverish  competition  in  trade  unquestionably  leads  to  much  of  the 
adulteration.  Efforts  at  underselling  reduce  the  prices  below  all  margin 
of  profit,  and  the  dealer  can  only  avoid  loss  by  selling  an  inferior,  adul¬ 
terated  article.  A  merchant  sees  goods  around  him  sold  at  prices  which 
he  knows  are  under  the  market  value  of  the  genuine  article.  Foolish 
seekers  after  so-called  “  bargains  "  are  attracted  by  such  bribes,  and  the 
merchant’s  trade  will  probably  be  drawn  away  unless  he,  too,  yield  to 
the  pressure  and  keep  the  cheap,  fraudulent  stuff  on  sale  himself.  Who 
is  to  call  the  halt  in  such  a  competition?  Which  of  the  competitors 
will  turn  back  to  honest  ways  ?  Nothing  but  the  stern  hand  of  the  law 
can  ever  put  a  stop  to  such  fraudulent  practices.  The  rich  can  buy  of 
high-priced  grocers,  and  even  they  are  often  deceived  in  the  safeguards 
they  imagine  thrown  around  their  purchaser.  The  great  mass  of  the 
people,  who  are  compelled  to  carefully  look  to  the  expenditure  of  every 
dime,  lack  knowledge  and  power  to  protect  themselves  from  deception 
and  injury.  Should  not  the  State  give  us  protection,  then? 

How  great  the  adulteration  of  food  in  North  Carolina  is,  we  have  no 
direct  means  of  judging  Wealth  is  lacking  as  a  safeguard,  however, 
and  dishonest  manufacturers  must  find  the  State  a  promising  field  for 
the  sale  of  their  wares.  Driven  from  the  markets  of  the  large  cities  by 
jealous  inspection  and  rigidly  enforced  laws,  they  find  defenceless  prey 
in  the  citizens  of  North  Carolina.  Fortunately,  as  an  agricultural  peo¬ 
ple,  much  of  the  food  is  home-raised,  but  coffee,  sugars,  spices,  cheese, 
canned  goods,  lard,  and  many  other  groceries  and  all  of  our  medicines 
are  beyond  our  control.  In  the  towns,  of  course,  the  number  of  articles 
of  food  gotten  from  outside  the  State  is  largely  increased. 

How  to  correct  this  state  of  affairs  and  put  an  effectual  check  to  the 
adulteration  of  foods  and  drugs  should  be  one  of  the  foremost  questions 
with  the  people,  and  will  become  the  cry  when  they  wake  up  to  the 


appendix. 


XXXIX 


dangers  threatening  them.  The  State,  by  proper  laws,  has  «establishe  d 
a  fertilizer  control  station,  which  has  enabled  the  farmer  to  secure  pure 
food  for  his  plants.  The  laws  have  worked  successfully  and  have  proved 
beneficial.  Cannot  the  same  power  interpose  in  behalf  of  the  food  of 
the  people— a  far  more  important  matter?  Wise  laws,  faithfully  and 
prudently  administered,  would  prove  a  blessing  to  the  retail  merchant 
as  well  as  to  the  consumer.  An  honest  dealer  would  be  glad  to  have  an 
inspection  which  would  enable  him  to  tell  whether  his  goods  were  pure 
or  not.  Only  a  short  time  ago  one  of  our  merchants  came  to  me  much 
troubled  about  his  goods.  He  suspected  adulteration  in  them  and 
wished  them  analyzed.  The  expense  of  single  private  analyses  prevented 
this,  and  he  was  forced  to  transfer  his  custom  from  one  Northern  whole¬ 
sale  firm  to  another  in  the  hope  of  finding  an  honest  one.  The  brunt  of 
the  law  should  fall  upon  the  wholesale  merchants  and  manufacturers. 

The  law  must  be  clear  and  direct,  and,  experience  has  shown.  \ery 
carefully  worded.  It  must  include  all  of  the  machinery  necessary  for 
its  enforcement,  providing  for  inspection,  analysis  and  the  suitable  pun¬ 
ishment  of  offenders.  Some  of  the  States  have  passed  laws  which  have 
become  dead  letters  from  Jack  of  this  very  machinery.  Several  of  the 
States  have  very  full  enactments  against  the  adulteration  of  food  which 
seems  to  have  worked  well.  Nearly  all  of  the  States  have  at  least  partial 
laws  on  the  subject.  I  hope,  in  the  not  far  distant  future,  this  State 
will  be  mused  to  the  necessity  for  some  such  law,  at  least  authorizing 
inspection  and  prohibition  of  the  sale  of  injurious  articles. 

The  question  may  be  raised  whether  such  laws  effect  any  diminution 
in  fraud.  The  records  of  the  Paris  municipal  laboratory,  of  which 
further  mention  will  be  made,  show  that  they  do.  This  laboratory 
reported  in  1881  that  the  following  proportions  of  the  samples  analyzed 
were  found  “bad”:  Milk  and  cream,  50.66  per  cent.;  wane,  59.17;  foods 
and  drugs  generally,  50.48.  The  November  report  for  1888,  after  seven 
years  enforcement  of  che  law,  shows,  of  milk,  9  per  cent. ;  wine,  etc.,  55; 
foods  and  drugs,  21  per  cent.  “  bad.”  A  very  wonderful  decrease. 

The  work  of  this  laboratory  extends  now  to  a  supervision  of  the  manu¬ 
facturing  establishments,  thus  striking  at  the  very  root  of  the  evil.  An 
incident  related  of  a  London  chocolate  and  cocoa  dealer  shows  the  neces¬ 
sity  for  watching  the  manufacturers.  This  dealer  was  desirous  of  secur¬ 
ing  pure  flake  cocoa  and  of  supplying  his  customers  with  the  same.  As 
he  was  unable  to  purchase  the  pure  article  at  the  factories,  he  secured 
pure  materials,  berries,  etc.,  and  took  them  to  a  factory  to  be  prepared 
for  him.  The  preparation  which  the  manufacturer  returned  him  from 
his  own  pure  materials  was  subjected  to  analysis  and  found  adulterated. 
The  dealer  was  forced  to  build  and  run  a  factory  himself  to  secure  the 
pure  article. 

Against  wine  adulteration  the  laws  do  not  seem  so  effective.  From 
the  time  of  the  Romans  it  has  been  a  fact  that  even  dealers  owning  vine- 


XL 


APPENDIX. 


yards  cannot  secure  pure  wines  of  the  more  famous  brands.  Such  a 
thing  as  pure  sherry,  for  instance,  is  not  to  be  procured.  German  experts 
are  actually  discussing  the  point  as  to  whether  a  different  law  or  a 
modification  of  the  existing  one  should  not  be  passed  for  this  special 
wino.  The  wine  is  tampered  with  in  spite  of  all  warnings,  and  Germany 
must  either  give  up  her  law  or  her  sherry.  But  such  cases  do  not  con¬ 
cern  the  people.  It  is  the  simple,  plain,  every-day  food  that  we  want 
pure,  and  only  by  governmental  intervention  can  its  purity  be  secured. 

The  struggle  against  adulteration  has  been  going  on  ever  since  man’s 
greed  overcame  his  honesty.  Governments  have  striven  to  protect  their 
subjects,  but  with  indifferent  success,  down  to  this  age,  in  which  the 
introduction  of  scientific  methods  of  inspection  and  testing  has  put  it 
into  their  power  to  tell  the  good  from  the  bad.  Greece  had  her  wine- 
inspectors,  England  her  “  ale-tasters  ”  and  “  assizes  of  bread.”  The 
crudity  of  general  tests  applied  is  well  illustrated  by  the  account 
given  of  the  way  in  which  the  “ale-tasters”  examined  the  liquors  for 
an  excess  of  sugar.  Clothed  in  leather  breeches,  they  sat  upon  a  wooden 
bench  on  which  some  of  the  liquid  had  been  spilled.  The  relative  diffi¬ 
culty  experienced  in  rising  gave  them  an  indication  of  ihe  amount  of 
sugar. 

The  old-time  laws  did  not  fail  for  lack  of  punitory  clauses— fines,  im¬ 
prisonment,  sitting  in  the  pillory  with  the  loaves  of  false  bread  tied 
about  the  neck,  or  parading  the  streets  with  similar  decorations,  riding 
for  a  day  enthroned  in  the  city  garbage-cart— everything,  down  to 
enforced  consumption  of  the  adulterated  articles.  This  latter  was  some¬ 
times  equivalent  to  the  death-penalty.  At  Biebrich-on-the-Rhine  a 
dealer  was  forced  to  drink  his  own  wine.  He  died  from  the  effects. 
Very  often  the  penalties  were  excessively  severe,  as  burning  and  bury¬ 
ing  alive,  in  Germany.  Yet  the  ease  with  which  they  escaped  detection 
and  the  profits  of  the  business  were  too  great  a  temptation.  Adultera¬ 
tion  flourished,  and  the  governments  were  unable  to  suppress  it.  Modern 
legislation  in  England  was  largely  brought  about  by  the  careful  scien¬ 
tific  work  of  the  distinguished  chemist  Aceum.  But  the  first  Parlia¬ 
mentary  commission  and  general  legislation  were  due  to  the  influence 
of  the  Lancet  and  its  Sanitary  Commission,  under  the  leadership  of  Dr. 
Hassall.  This  Commission  was  appointed  in  1855,  and  effective  legisla¬ 
tion  in  England  on  this  subject  dates  from  that  year. 

Mere  legislation,  without  proper  machinery  for  enforcement  of  the 
laws,  will  not  check  adulteration.  The  case  of  France  may  be  cited  as 
one  of  inefficient  legislation  at  first,  afterwards  made  effectual  by  a 
system  of  inspection,  fints  and  publication  of  the  offences.  The  account 
is  taken  from  Count  Wihair’s  report.  Under  the  laws  of  France  the 
average  yearly  convictions  from  1846-1850  was  196;  1851-1855,  6,780; 
1856-1860,  8,442;  1861-1865,  4,605;  1866-1870,  3,014;  1871-1875,  3,209; 
1876-1880,  3,398. 


APPENDIX. 


XLI 


In  spite  of  these  con^  ic lions,  adulteration  of  foods  and  drugs  was  very 
common.  The  difficulty  of  detection,  the  indifference  of  the  public, 
the  small  amount  involved  in  each  transaction,  the  trouble,  annovance 
and  expense  of  prosecution  and  the  doubtful  recompense  following  it, 
even  in  cases  of  success,  were  causes  operating  upon  human  nature 
applying  in  France  as  well  as  elsewhere. 

In  January,  1881,  was  established  the  most  effective  engine  against 
adulteration  yet  devised — the  municipal  laboratory  already  mentioned. 
Scientific  experts  analyzed  samples  brought  them  by  inspectors  or  the 
general  public,  and  the  results  are  still  regularly  published.  Manufac¬ 
turing  establishments  are  visited  and  everything  fraudulent  confiscated. 
Those  guilty  of  breaches  of  law  are  prosecuted  and  in  every  respect  the 
law  firmly  administersd:  24,655  visits  of  inspection  were  made  in  1881; 
a  great  many  more  are  made  now  annually;  6,517  specimens  were  ana¬ 
lyzed  in  1881;  between  2,000  and  3,000  per  month  are  analyzed  now. 
The  cost  to  the  public  is  made  exceedingly  low.  The  result  has  been 
that  the  number  of  samples  found  adulterated  has  been  reduced  over  50 
percent.  The  certainty  of  inspection,  examination  and  the  publicity 
are  having  due  effect. 

It  seems  to  me  North  Carolina  might  adopt,  at  a  low  cost,  a  system  of 
inspection  making  public  the  results.  Much  would  be  gained  by  it. 
This  State  has  now  the  proud  privilege  of  being  one  of  the  only  three  in 
the  Union  without  legislation  against  adulteration.  The  others  are 
Arkansas  and  Mississippi.  There  is  a  law,  however,  allowing  those 
desiring  to  have  analyses  of  suspected  articles  to  he  made  through  tne 
Board  of  Health. 

It  seems  to  me  clearly  the  duty  of  North  Carolina  to  protect  her  citi¬ 
zens  in  this  matter  so  important  to  their  welfare.  The  citizen  should 
demand  it  as  his  right,  for  individually  he  is  helpless  against  the  pur¬ 
veyors  of  his  foods  and  medicines.  It  will  cost  the  State  something,  of 
course,  but  can  we  afford  to  be  “  penny  wise  and  pound  foolish”?  To 
quote  a  distinguished  Frenchman,  “It  is  an  axiom  universally  admitted 
at  the  present  day  that  no  expenditures  of  the  government  prove  so 
profitable  as  those  which  are  made  in  bettering  the  public  hygiene.” 


XLII 


APPENDIX. 


HOW  CAN  WE  BEST  SECURE  ECONOMICAL  DISPOSAL  OF 

REFUSE  IN  OUR  TOWNS  ? 


By  J.  L.  Ludlow,  C.  E.,  M.  S.,  Civil  and  Sanitary  Engineer, 

Winston,  N.  C. 


In  the  great  book  of  nature  we  are  taught  that  extreme  dangers 
attend  the  accumulation  of  filth  within  communities  of  human  habita¬ 
tions.  We  are  taught  that  the  products  of  the  vegetable  kingdom, 
having  once  served  the  uses  of  man  as  food,  and  having  passed  from  the 
body  as  the  waste  product  of  the  animal  kingdom,  has  become  a  delete¬ 
rious  substance,  unfit  for  the  uses  or  surroundings  of  mankind,  at  least 
until  it  has  been  given  an  opportunity  of  passing  through  nature’s  trans¬ 
forming  cycle,  to  reappear  as  vegetable  matter  fit  again  for  the  support 
of  the  animal  kingdom. 

This  simple  lesson  has  been  sadly  demonstrated  in  many  cases  of  pre¬ 
ventable  sickness,  deaths  and  serious  epidemics,  until  at  last  it  is  to  be 
hoped  that  the  necessity  of  filth  removal  and  disposal  has  become  fully 
realized  by  every  intelligent  thinking  human  being.  It  affords  me 
extreme  pleasure  to  reasonably  assume  that  this  is  emphatically  the  case 
with  such  an  audience  upon  such  an  occasion  as  this,  so  that  I  may  con¬ 
fine  myself  to  the  essential  object  of  my  theme,  the  economic  disposal, 
after  removal  has  been  accomplished.  I  shall  endeavor  to  present  the 
subject  from  a  thoroughly  sanitary  standpoint,  believing  as  I  do  firmly 
that  no  method  that  is  insanitary  is  economical. 

The  filth  to  be  removed  and  disposed  of  may  be  comprehensively 
classified  as  Sewage  and  Garbage.  By  Sewage  is  understood  the  ani¬ 
mal  excretions  and  the  fluid  and  semi-fluid  refuse  of  the  abodes  of 
mankind  and  of  factories.  By  Garbage  is  embraced  the  solid  animal 
and  vegetable  refuse  of  dwellings,  stores  and  other  abodes,  such  filth 
as  is  common  in  the  street-sweepings,  ash  barrels  and  market  refuse. 

The  substance  of  sewage  and  garbage  being  radically  different  in  their 
composition,  are  subject  to  very  different  methods  of  disposal,  though 
some  methods  are  measurably  applicable  to  both,  and  in  some  cases  the 
two  may  be  operated  upon  in  combination. 

In  a  recently  prepared  paper  for  the  Biennial  Report  of  the  North 
Carolina  Board  of  Health  I  have  endeavored  to  demonstrate  that  the 
most  sanitary  and  most  economic  method  of  sewage  removal  is  by  a 
water  carriage  system  of  sewers  of  the  “separate  system.”  Garbage 
must  be  removed  by  manual  and  horse  labor.  In  some  cases  they  should 
be  removed  to  the  same  point,  in  others  to  different  points,  as  will  appear 
in  what  follows.  I  will  thus  dismiss  the  subject  of  removal  and  pass 
first  to  the 


APPENDIX. 


XLIII 


DISPOSAL  OF  SEWAGE. 

When  the  sewage  has  been  conducted  by  the  sewers  to  a  suitable  outfall, 
beyond  the  point  where  it  might  exercise  a  dangerously  contaminating 
influence  upon  the  atmosphere  and  health  of  the  community,  it  may  be 
turned  into  a  natural  water-course  of  sufficient  magnitude  with  practical 
safety,  except  in  closely  populated  districts  where  towns  are  at  close 
intervals  along  the  stream,  or  where  the  public  water  supply  of  one 
town  may  be  taken  from  the  same  stream  that  contains  the  sewage  of 
the  towns  above  it 

Though  there  be  several  matters  to  be  taken  into  consideration  before 
turning  the  sewage  of  large  towns  and  cities  into  the  natural  water¬ 
courses,  where  such  disposal  of  the  sewage  is  practicable  it  affords  a 
simple  and  apparently  economic  solution  of  the  problem.  Its  economy 
is  questioned  on  the  ground  of  the  thereby  wasted  manurial  properties 
contained  in  the  sewage.  In  a  country  needing  and  using  a  great  quan¬ 
tity  of  artificial  fertilizers  this  objection  becomes  an  extremely  valid 
one  and  renders  the  various  utilization  schemes  a  suitable  subject  for 
our  consideration. 

It  can  hardly  be  questioned  that  at  least  a  partial  purification  and  utili¬ 
zation  of  sewage  is  desirable  from  an  economic  sanitary  standpoint. 
We  have  the  record  of  many  cases  where  sewage  utilization  has  been 
practiced  with  profit  as  well  as  to  great  sanitary  advantage. 

From  time  to  time  various  plans  have  been  brought  out,  and  experi¬ 
mented  with,  for  disposing  of  sewage  in  a  satisfactory  manner.  Some  of 
these  have  demonstrated  their  own  inadequacy ,  while  others  have  proved 
themselves  of  great  efficiency.  The  various  methods  may  be  compre¬ 
hensively  classified  as  follows,  viz.:  Burning,  Freezing,  Electricity, 
Distillation,  Filtration,  Precipitation,  and  Irrigation  on  Land.  In  what 
follows  I  shall  attempt  to  briefly  describe  and  to  point  out  the  defects, 
merits  and  adaptability  of  these  various  expedients. 

Burning. — Assuming  a  sewage  flow  of  60  gallons  per  capita  per  day 
the  composition  of  sewage  from  a  “  separate  system  would  be  practi¬ 
cally  158  parts  of  solids  in  100,000  parts  of  sewage.  Thus  it  will  be  readily 
seen  that  the  great  proportion  of  water  prevents  the  practical  applica¬ 
tion  of  this  system. 

Freezing. — The  presumed  utility  of  this  plan  was  based  upon  the  sup¬ 
posed  purification  effected  by  the  process  ot  freezing  water.  It  was 
proposed  to  thus  free  the  sewage  from  the  greater  portion  of  the 
water  contained  in  it,  and  to  obtain  a  harmless  and  useful  product,  as 
ice.  It  is  now,  however,  so  well  determined  that  water  in  fieezing 
entangles  suspended  and  dissolved  impurities,  and,  moreover,  that  many 
forms  of  microbia  are  not  in  the  least  affected  by  freezing,  that  this  pro¬ 
cess  must  be  put  under  the  ban  as  insanitary  and  impractical. 


XLI V 


APPENDIX. 


Electricity. — Under  this  plan  it  is  proposed  to  effect  a  separation  of 
the  organic  and  inorganic  substances  of  sewage  by  “galvanic,  magnetic 
or  electrical  action.”  This  is  to  be  effected  by  passing  magnetic  or  elec¬ 
tric  currents  through  the  mass  and  thereby  ozonizing  the  sewage. 
From  the  few  experiments  of  which  we  have  record  it  is  shown  that  this 
plan  has  but  feeble  capacity  for  fulfilling  the  claims  made  for  it.  At 
any  rate,  the  separation  of  the  parts  of  sewage  can  be  accomplished  by 
other  and  more  economic  means. 

Distillation. — In  this  process  it  is  first  proposed  to  precipitate  the 
sewage  by  chemical  agencies,  and  to  treat  the  sediment  by  acids  and  heat 
in  closed  retorts  to  extract  the  oils  and  fatty  substances.  While  partial 
success  attends  a  similar  treatment  of  garbage — “  Vienna  Garbage  Pro¬ 
cess” — it  is  hardly  probable  that  enough  of  these  products  are  contained 
in  sewage  sludge  to  render  a  return  comparable  with  the  cost.  Further, 
the  harmful  elements,  most  of  which  are  contained  in  the  effluent  from 
precipitation,  cannot  be  practically  treated  by  such  a  process.  Hence, 
this  process  must  be  classed  as  insanitary  in  itself,  though  it  may  have 
some  merit  when  operated  in  combination  with  some  other  method. 

Filtration. — In  this  system  the  sewage,  as  it  is  delivered  at  the  out¬ 
fall  is  passed  upon  and  through  prepared  beds  of  sand,  gravel,  ashes, 
shavings,  straw,  burnt  clay,  animal  charcoal,  wood  charcoal,  or  other 
porous  material. 

The  action  is  to  arrest  the  solid  matters  suspended  in  the  sewage  and 
retain  them  upon  or  in  the  filter-bed.  In  passing  through  the  filter  the 
atmospheric  air  contained  in  the  filter  and  drawn  in  with  the  sewage 
in  a  measure  oxidizes  the  organic  matter  contained  therein,  rendering 
the  liquid  effluent  measurably  purified. 

There  have  been  practiced  two  different  methods  of  filtration — down¬ 
ward  and  upward.  The  downward  filtratioi  being  the  most  natural,  is 
the  most  efficient  and  of  the  most  common  use.  By  this  method  the 
sewage  is  applied  at  the  top  of  the  filter,  passes  downward,  the  effluent 
entering  provided  drains  or  receptacles  at  the  bottom. 

The  efficiency  of  a  filtration  plant  will  be  almost  wholly  dependent 
upon  the  skill  and  care  with  which  the  filter  is  prepared,  and  upon  the 
size  of  the  filter  proportionate  to  the  quantity  of  sewage  to  be  filtered. 

The  filtering  material  not  destroying,  but  retaining  the  suspended 
impurities  of  the  sewage,  will  become  extremely  foul.  It  must  then  be 
either  cleansed  or  renewed.  Cleansing  the  filter  of  these  impurities, 
which  naturally  have  become  to  a  very  advanced  state  of  putrefaction, 
is  a  serious  difficulty.  If  it  is  washed  by  water,  what  is  to  be  done  with 
the  resultant,  it  being  almost  as  foul  as  the  original  sewage.  If  it  be 
dried,  a  nuisance  is  the  probable  result,  as  well  as  serious  damage  to  the 
filtering  material.  If  it  be  burned,  a  total  loss  of  the  manurial  proper¬ 
ties,  as  well  as  of  the  filtering  material,  is  the  result. 


» 


APPENDIX. 


XLV 


It  will  be  well  to  notice  here  what  is  the  manurial  loss  when  sewage 
is  burned,  or  turned  in  its  crude  state  into  a  water-course.  The  chief 
fertilizing  ingredients  of  sewage  are  ammonia,  phosphoric  acid  and 
potash.  The  amount  of  these  voided  annually  by  the  average  individual 
of  a  mixed  population  of  all  ages  and  both  sexes,  according  to  the  best 
analysis,  is  12.96  pounds  of  ammonia,  5.23  pounds  of  phosphoric  acid, 
and  2.9  pounds  of  potash.  Their  combined  value,  based  upon  their 
values  as  constituents  of  concentrated  artificial  manure,  such  as  guano 
and  the  various  brands  of  commercial  fertilizers,  is  $2.25.  Then  we  have 
$22,500  as  the  manurial  value  of  the  annual  sewage  of  a  town  of  10,000 
population.  It  should  be  noted,  too,  that  this  valuation  does  not  take 
into  account  the  fatty  substances  and  vegetable  matter  from  kitchen 
slops,  nor  the  organic  matters  from  stables  and  slaughter-houses  which 
may  be  turned  into  the  sewers.  Neither  does  it  include  various  other 
putrescible  matters  always  present  in  town  sewage.  When  it  is  consid¬ 
ered  that  all  these  fertilizing  ingredients  have  been  taken  directly  from 
the  soil,  their  wholesale  destruction  and  non-utilization  must  appear  a 
serious  error. 

As  a  result  of  a  great  number  of  analyses  by  Messrs.  Lawes  and  Gilbert, 
and  other  authoritative  analysts,  it  is  shown  that  of  the  12.96  pounds  of 
ammonia  voided  annually  11.82  are  contained  in  the  urine  and  but  1.64 
in  the  faeces.  Of  the  5.23  pounds  of  phosphoric  acid,  3.85  are  contained 
in  the  urine  and  but  1.38  parts  in  the  fmces.  Further,  it  was  determined 
by  the  Rivers  Pollution  Commissioners  that  in  100,000  parts  of  London 
sewage  there  were  but  44.69  parts  of  suspended  matters,  while  the  total 
solids  in  solution  was  72.2  parts;  and  it  was  deduced  that  of  the  money 
value  of  the  fertilizer  ingredients  of  the  sewage  15  parts  were  in  solution 
to  2  parts  in  suspension.  Now,  it  must  be  observed  that  the  manurial 
elements  of  sewage  almost  accurately  correspond  to  the  harmful  sub¬ 
stances.  Then  it  will  be  clear  that  any  method  of  treating  sew  age  which 
does  not  contemplate  the  arrest  of  the  impurities  in  solution  must  fall 
far  short  of  being  a  satisfactory  disposal,  either  from  an  economic  or 
sanitary  standpoint.  Hence,  Filtration,  though  arresting  and  peihaps 
deodorizing  all  the  suspended  impurities,  but  passing  almost  unchanged 
the  soluble  ingredients,  must  of  itself  be  condemned  as  an  incomplete 
and  altogether  unsatisfactory  system  of  sewage  disposal. 

Precipitation. — In  this  system  various  chemicals,  mineials,  albumi¬ 
noids  and  other  substances  are  utilized  to  effect  a  dissolution  of  the 
natural  combinations  in  sewage.  The  various  processes  under  this  head 
cover  such  a  wide  field,  both  in  their  number  and  range  of  principles, 
that  to  satisfactorily  epitomize  them  is  a  difficult  task  in  the  proper 
magnitude  of  a  paper  for  this  occasion.  I  can,  at  best,  only  direct 
attention  to  the  broad  and  admirable  utility  of  this  system  uf  sewage 

disposal. 


XL  VI 


APPENDIX. 


Under  this  system  we  have  a  means  of  abstracting  all  the  suspended 
and  nearly  all  of  the  dangerous  dissolved  impurities.  We  have  the  sew¬ 
age  in  a  suitable  condition  for  complete  purification  and  utilization  by 
the  action  of  the  soil  and  of  growing  plants. 

Briefly  described,  it  consists  of  effecting  a  thorough  admixture  of  the 
sewage  with  precipitating  agents  and  collecting  the  mixed  product  in  a 
series  of  tanks  at  the  outfall.  While  at  rest  in  the  tanks,  the  precipitants> 
in  the  action  of  precipitation  proper,  and  of  seclusion  or  absorption, 
cause  a  subsidence  to  the  bottom  of  suspended  and  dissolved  impurities.. 
It  should  be  observed  here  that  a  precipitating  agent  which  forms  an 
insoluble  precipitate  with  ammonia,  phosphoric  acid  or  potash  would  be- 
objectionable  in  case  utilization  on  land  is  a  desideratum. 

The  sewage,  after  having  passed  through  three  or  four  successive  pre¬ 
cipitations,  is  reduced  to  a  comparatively  pure  effluent,  when  it  may  be 
turned  into  any  small  water-course  or  further  purified  upon  land. 

The  residue  in  the  tanks  containing  the  putrescent  and  other  deleteri¬ 
ous  but  manurial  properties  is  in  a  semi-fluid  state,  containing  perhaps 
90  per  cent,  of  water.  This  may  be  further  dried  by  various  plans,  and 
rendered  into  a  suitable  form  for  utilization  as  fertilizers. 

The  manurial  value  of  the  sludge  will  be  directly  dependent  upon  the 
completeness  of  the  precipitating  process.  Likewise  the  precipitating 
agents  should  be  determined  according  to  the  extent  of  purification  and 
manurial  retention  relatively  desired  in  the  sludge  and  effluent  liquid. 
If  it  is  intended  to  continue  the  purification  process  by  irrigating  land 
with  the  liquid  effluent,  the  extent  of  purification  may  be  greatly  les¬ 
sened  in  the  precipitating  tanks,  with  a  corresponding  decrease  in  th& 
cost.  In  such  a  case  a  simple  treatment  with  milk  of  lime  or  lime-water 
would  arrest  the  suspended  impurities  and  give  an  effluent  in  a  suitable 
condition  for  purification  by  the  soil  and  growing  crops. 

The  lime  treatment,  augmented  by  a  further  treatment  of  sulphate  or 
a  salt  of  alumina,  with  an  occasional  treatment  of  iron,  will  give  a  com¬ 
paratively  pure  effluent,  retaining  most  of  the  organic  impurities,  dis¬ 
solved  and  suspended,  in  the  precipitate.  Still  further  aiding  this  by 
the  use  of  proper  absorbents  would  probably  retain  95  per  cent,  of  all 
the  sewage  impurities  in  the  precipitated  sludge.  The  substances 
escaping  precipitation  would  probably  be  a  portion  of  the  oils  and  fats, 
ammoniacal  salts  and  the  alkaline  nitrates  and  nitrites.  Though  these 
escaping  substances  are  practically  harmless,  their  loss  is  to  be  regretted, 
owing  to  their  manurial  value  and  to  the  possible  chance  of  their  being 
changed  to  a  putrescible  condition  by  coming  in  contact  with  living 
organisms.  This  loss  is  less  to  be  regretted,  however,  in  the  case  of 
nitrates  and  nitrites,  since  they  serve  as  a  safeguard  against  the  danger 
of  appropriating  the  effluent  water  for  domestic  uses,  their  presence  in 
water  being  generally  taken  as  prima  facie  evidence  of  previous  sewage, 
contamination. 


APPENDIX. 


XLVII 


It  should  be  observed  here  that  the  complete  results  indicated  above 
have  not  been  attained  in  the  various  precipitation  processes  which  have 
been  practiced  in  many  towns  and  cities  of  Europe;  but,  relative  to  this, 
it  must  be  considered  that  the  European  practice  has  been,  in  many  if 
not  most  cases,  in  connection  with  the  combined  or  storm- water  system 
of  sewers,  and  where  the  relative  volume  of  solids  in  suspension  to  that 
in  solution  would  be  much  greater  than  in  the  sewage  collected  by  the 
“  separate  system,  making  much  more  complex  and  difficult  the  process 
of  precipitation. 

It  may  be  safely  concluded  that  a  precipitation  process,  with  properly 
selected  precipitants,  deodorizers  and  absorbents,  affords  a  very  satisfac¬ 
tory  system  of  disposing  of  a  great  portion  of  the  impurities  contained 
in  the  sewage  of  towns  and  cities,  though  a  complete  disposal  by  this 
process  may  be  prohibitory  from  its  great  cost,  relative  to  a  similar 
completed  disposal  by  irrigation. 

Irrigation. — This  system  I  shall  discuss  under  three  (3)  subdivisions, 
viz. :  Broad,  Surface  Irrigation ,  Contracted  Surface  Irrigation ,  and 
Sub-surface  Irrigation.  The  essential  principle  of  each  of  these  is  the 
same,  viz.,  that  the  soil  is  the  natural  purifier  or  contains  nature’s  agen¬ 
cies  for  the  purification  of  excrementitious  and  other  putrescent  matters; 
that  it  is  the  natural  agency  of  the  conservation  of  energy,  in  that  it 
transforms  the  waste  products  of  animal  life  into  vegetable  matters, 
again  suitable  and  necessary  for  the  support  of  animal  life. 

Underlying  all  the  great  and  immutable  laws  of  nature,  there  is  one 
physical  law  greater  than  all  others,  in  that  the  continued  operation  of 
all  the  other  laws  is  dependent  upon  this.  This  law  is  known  as  the 
principle  of  the  conservation  of  energy.  By  it  all  of  the  energy  in 
nature  is  preserved  indestructible.  It  may  be  transformed,  but  it  can¬ 
not  be  destroyed. 

The  continuation  of  animal  life  is  due  to  the  transformation  of  the 
potential  energy  in  the  plant,  to  energy  of  rest  and  of  motion  in  the 
animal  kingdom.  That  wasted  energy  of  man  exists  in  excrement  is 
undoubtedly  proven  by  its  rapid  transformation  into  myriads  of  micro¬ 
organisms  which  are  destructive  to  animal  life.  That  this  energy  is 
again  transformed  by  the  soil  into  suitable  shape  for  the  uses  of  animals 
is  amply  attested  by  the  luxuriant  vegetation  on  fertilized  land,  and  by 
the  barren  fields  where  fertilizing  is  not  practiced.  Having  such  evi¬ 
dence  of  the  transformation  of  energy  and  consequent  annihilation  of 
putrescent  impurities,  it  must  be  accepted  as  a  justifiable  claim  that  the 
soil  is  nature’s  agency  for  effecting  filth  purification. 

The  process  by  which  the  soil  transforms  putrescent  matters  into  food 
for  roots  and  plants  is  known  as  nitrification,  and  consists  in  the  conver¬ 
sion  of  ammonia  and  the  nitrogen  of  organic  matter  into  nitiic  acid.  It 
is  effected  by  the  agency  of  lining  organisms  which  exist  in  soils  to  a 
depth  of  three  or  four  feet  and  act  as  a  ferment  upon  the  substances  to 

be  purified. 


XLVIII 


APPENDIX. 


Broad  Irrigation  means  that  the  sewage  is  to  be  utilized  in  the  treat¬ 
ment  of  a  large  area  of  agricultural  land,  having  in  view  the  application 
of  just  sufficient  sewage  to  feed  the  growing  crops,  thus  effecting  the 
purification  and  the  abstraction  of  all  the  manurial  impurities  of  the 
sewage.  The  soil  is  not  supposed  to  have  any  artificial  drainage;  conse¬ 
quently,  all  the  water  contained  in  the  sewage  must  be  either  absorbed 
or  evaporated.  Now,  the  amount  of  sewage  of  a  10,000  population  town 
would  be  equivalent  to  a  mean  annual  rainfall  of  45  inches  on  150  acres 
of  land.  The  evaporation  from  the  soil  is  naturally  about  75  per  cent, 
of  the  rainfall.  The  amount  of  water  carried  off  through  the  soil,  then, 
amounts  to  Hi  inches.  To  double  the  quantity  of  water  on  the  soil  by 
irrigating  with  sewage,  we  might  expect  an  evaporation  of  50  per  cent, 
of  the  whole,  leaving  four  times  the  natural  amount  of  water  to  be  car¬ 
ried  off  through  the  soil.  It  will  be  clear,  then,  that  unless  the  irrigating 
area  is  very  great,  the  soil  will  become  water-logged,  and.  in  a  few  years, 
be  not  unlike  a  vast  meadow  or  swamp.  This  contingency  might  be 
overcome  by  a  net-work  of  open  ditches  ramifying  through  the  irrigat¬ 
ing  area;  but  this  would  encourage  flowing  over  the  soil  instead  of 
through  it,  with  the  result  of  great  loss  of  dissolved  manurial  properties 
and  incomplete  purification. 

Other  than  the  objection  of  the  vast  area  required,  the  system  of  broad 
irrigation  is  admirably  adapted  for  sewage  disposal  and  utilization  when 
the  sew’age  is  all  absorbed  by  the  soil,  and  yet  does  not  render  it  too  cold 
and  wet  for  the  growth  of  crops. 

In  all  the  systems  of  irrigation  there  is  one  imperative  requisite,  viz.: 
that  the  suspended  matters  be  removed  before  the  seyyage  is  passed  upon 
the  land.  If  this  is  not  accomplished,  putrefaction  must  take  place  upon 
the  surface,  with  a  consequent  nuisance  and  loss  of  manurial  properties. 
More  than  this,  the  pores  of  the  soil  will  become  clogged,  with  a  conse¬ 
quent  loss  of  nitrifying  capacity. 

Contracted  Surface  Irrigation,  or  intermittent  downward  filtration, 
differs  from  broad  irrigation  in  that  it  contemplates  the  irrigation  of  a 
quantity  of  soil  just  sufficient  to  purify  the  sewage,  with  secondary  con¬ 
sideration  to  the  extent  of  utilization  in  the  growth  of  plants.  It  is  also 
intended  that  the  soil  shall  not  only  serve  in  its  absorbing  and  nitrifying 
capacity,  but  that  it  shall  also  serve  as  a  filter,  passing  the  purified 
water  through  and  away  from  the  irrigated  area  by  means  of  a  system 
of  under-drainage. 

We  have  various  examples  to  prove  that  under  this  system  the  sewage 
has  been  very  completely  purified,  the  organic  impurities  being  reduced 
to  a  mere  trace  in  the  effluent.  But  it  will  be  readily  observed  that  by 
applying  the  sewage  to  such  contracted  space,  say  one  (1)  or  one-half  (•£) 
acre  per  1,000  population,  the  complete  utilization  cannot  be  accom¬ 
plished  by  the  growing  crops,  the  sewage  being  applied  to  the  soil  at  all 
times,  whether  it  is  beneficial  or  injurious  to  the  crops. 


APPENDIX. 


XLIX 


Iii  the  successful  operation  of  this  system  intermittency  of  application 
of  the  sewage  is  an  essential  feature.  By  this  means  t lie  sections,  when 
thoroughly  taxed,  are  given  an  opportunity  of  self- purification  by  drying 
out  and  having  the  pores  in  the  soil  recharged  with  a  fresh  supply  of  air. 
To  this  end  the  irrigating  area  is  generally  subdivided  into  three  or  four 
parts;  if  in  four  parts,  then  each  part  has  six  hours  of  service  to  eighteen 
of  rest,  whereby  the  efficiency  is  greatly  increased. 

Sub-surface  Irrigation.—  This  consists  of  applying  the  liquid  effluent 
of  sewage  to  the  soil  by  means  of  open-jointed  drain  tiles  laid  some  eight 
or  ten  inches  below  the  surface.  From  the  tiles  the  sewage  soaks  into 
the  surrounding  soil  and  is  utilized  by  growing  plants.  The  efficiency 
of  this  system  is  much  aided  by  under-drainage  of  the  treated  area.  It 
is  admirably  adapted  to  suburban  residences,  where  it  may  be  thus  safely 
disposed  of  in  the  back-yard  without  causing  the  least  nuisance.  The 
system  is  also  well  adapted  for  isolated  public  institutions,  but  it  is  ill- 
adapted  on  a  sufficiently  large  scale  for  towns  and  cities. 

Illustrating  the  efficiency  of  the  irrigation  system,  I  will  quote  from 
the  admirable  work  on  sewage  treatment  and  utilization  by  W.  H.  Cor- 
field:  “At  the  Lodge  farm,  near  Barking,  England,  where  the  soil  is 
gravelly  and  very  porous,  it  was  found  that  the  organic  nitrogen  of  the 
sewage  was  reduced  from  3.66  to  1.87  parts  per  100,000  by  fifty  or  sixty 
yards  of  surface-flow;  after  a  further  surface-flow,  to  .624;  and,  at  the 
issue  of  the  main  drain  of  the  farm,  to  .329  parts  per  100,000;  the  ammonia 
being  reduced  during  the  same  flow  from  4  to  0.8  parts  per  100,000, 
while  the  nitrates  and  nitrites,  which  were  absent  from  the  sewage, 
appeared  in  the  effluent  water  to  the  extent  of  nearly  3  parts  per  100,000.” 
This  latter  change  would  indicate  that  nitrification  by  the  soil  had  been 
very  complete. 

Again,  at  Breton’s  farm,  near  Romford,  England,  the  experiments  of 
the  committee  of  the  British  Association  shows  “  that  the  porportion  of 
nitrogen  escaping  in  the  effluent  water  to  the  total  quantity  applied  is 
.1067,  or  about  one-tenth.” 

Many  other  instances  might  be  cited,  all  of  them  showing  that  the 
impurities  of  the  sewage,  when  applied  to  practical  irrigation,  are  almost 
wholly  eliminated  from  the  effluent  water. 

Though  these  brief,  rambling  remarks  may  not  indicate  such  great 
capabilities  as  are  really  possessed  by  precipitation  and  irrigation,  yet  in 
the  light  of  all  the  facts,  brought  out  by  a  wide,  practical  application  of 
these  systems,  the  broad  statement  may  be  made,  viz.:  That  given  town 
sewage,  a  process  of  precipitation  with  deodorization,  supplemented  by 
subjecting  the  liquid  effluent  to  intermittent  downward  filtration 
through  prepared  soil,  and  the  application  of  the  precipitated  sludge  as 
a  fertilizer,  will  effect  a  practical  purification  of  the  sewage  and  quite 
extensive  utilization  by  growing  crops.  Further,  by  supplementing 
precipitation  by  broad  irrigation  will  so  purify  the  sewage  that  the  efflu- 


L 


APPENDIX. 


ent  may  be  fit  for  all  other  than  dietetic  uses,  with  a  complete  utilization 
of  the  manurial  parts  of  the  sewage  by  the  growth  of  various  crops. 

That  the  sewage  can  also  be  utilized  profitably  by  this  system  is  shown 
by  the  results  of  the  Pullman,  Illinois,  system  of  irrigation,  where  an 
annual  profit  of  more  than  $4,000  has  been  accomplished.  It  is  well  to 
observe  here  also  that  Pullman  is  an  extremely  healthy  cityr,  having  an 
actual  death-rate  of  but  seven  or  eight  per  thousand  inhabitants. 

DISPOSAL  OF  GARBAGE. 

Of  this,  I  propose  to  discuss  two  methods,  viz.:  Utilization  with  Sew¬ 
age  Sludge  as  Fertilizer,  and  Destruction  by  Fire. 

Before  entering  into  the  methods  of  disposal,  however,  it  is  necessary 
to  understand  clearly  the  composition  of  the  substance  to  be  disposed 
of.  To  determine  this,  I  will  quote  from  a  recent  report  on  the  Destruc¬ 
tion  of  Town  Refuse,  by  Mr.  Thomas  Codrington,  M.  Inst.,  C.  E.:  “In 
towns  in  which  water-closets  are  general,  the  house  refuse  consists  of 
cinders  and  ashes  mixed  with  vegetable  and  animal  waste,  broken  glass 
and  crockery,  and  tbe  rubbish  of  all  sorts  that  finds  its  way  into  the 
dust-bin  or  ash-pit,  including  often  trade  refuse  and  garden  refuse  in 
greater  or  less  proportion.  In  some  towns  the  trade  refuse,  market 
garbage  and  the  sweeping  of  paved  streets  amount  to  as  much  as  the 
house  refuse.  The  trade  refuse  consists  of  coarse  paper,  straw,  shavings, 
broken  stoneware  and  glass,  engine  ashes,  brick  rubbish,  spoilt  fruit, 
fish  and  turned  provisions,  etc.  Market  refuse  is  strictly  the  animal  and 
vegetable  matters  removed  from  markets,  but  it  is  often  mixed  with 
other  refuse.” 

“The  annual  reports  of  Mr.  G.  Weston,  the  surveyor  of  the  parish  of 
Paddington,  give  the  constituents  of  the  dust  collected  from  a  popula¬ 
tion  of  about  112,000,  and  they  may  be  taken  as  giving  the  fair  average 
composition  of  London  town  refuse.  In  1880,  20,600  tons  of  “dust” 
were  collected,  and  the  materials,  when  sorted  out,  were  in  the  following 
proportions  per  1,000  tons — other  years  give  much  the  same  results: 


London  Refuse.  Per  1,000  tons. 

Ashes  . . 526  tons. 

Breeze  (cinders) . 288  “ 

Soft  core  (animal  and  vegetable  refuse) . 142  “ 

Hard  core  (broken  pottery,  etc.) .  29  “ 

Coal . H  “ 

Bones  . . . .  “ 

Rags . 4  i  “ 

Old  iron.. .  3£  “ 

Old  metals  (brass,  pewter,  etc.) .  ^  “ 

White  glass . f  “ 

Black  glass .  2^  “ 


1,000  tons. 


APPENDIX. 


LI 


Some  of  tli6  haid  coie  is  used  for  road  foundations,  and  the  soft  core 
is  sometimes  mixed  \\  ith  garbage  and  street  sweepings  and  sent  away 
as  farm  manure. 

Where  the  privy  and  ash-pit  system,  or  the  pail  system  is  in  use,  the 
finei  ashes  aie  mixed  with  excreta,  either  in  the  closet  or  subsequently, 
to  make  a  portable  manure,  and  the  contents  of  the  ash-pits  are  gener¬ 
ally  more  or  less  fouled  with  excrementitious  matter.  In  Manchester, 
where  pail-closets  prevail,  of  1,000  tons  collected  from  the  closets  and 
ash-pits  in  1880,  the  constituent  parts  seem  to  have  been  as  follows: 


Manchester  Refuse.  per  1,000  tons. 

Ashes  and  excreta  in  pails _ _ 645  tons. 

Dust  and  cinders  _ _ _ _ _ _ _ _  345^  4  4 

Fish  and  bones . . . . .  14  44 


Dogs,  cats,  hens,  rabbits,  etc. 
Boots,  rags,  hats,  paper,  etc. . 


Vegetable  refuse . . . .  1  44 

Glass,  pottery,  bricks,  etc.  . . . . . . .  6  “ 

Old  iron  and  tinware  ..  . . . . .  4  44 


1,000  tons. 

For  every  1,000  tons  collected  from  the  closets  and  asli-pits,  about  290 
tons  of  slaughter-house,  market  and  shop  refuse,  and  street  sweepings 
were  besides  collected — the  whole  being  about  250,000  tons.” 

The  quantity  of  town  refuse  seems  to  range  from  200  to  300  tons  per 
year  per  thousand  population. 

Now,  I  will  consider  that  the  garbage  is  collected  at  the  outfall  of  the 
sewerage  system;  that  the  sewage  is  subjected  to  a  precipitation  process, 
retaining  much  of  the  manurial  properties  in  the  precipitate;  that  the 
precipitated  sludge  requires  artificial  drying  or  an  addition  of  some  dry 
substance  to  render  it  in  a  portable  shape  to  be  utilized  as  a  fertilizer; 
then  determining  the  approximate  composition  of  the  garbage  from  the 
data  given  above,  we  shall  see  what  disposition  can  be  made  of  it.  We 
may  safely  take  the  table  of  London  sewage  as  a  fair  specimen  of  the 
composition  of  the  garbage  of  a  sewered  town.  Of  this,  all  the  ashes, 
one-half  of  the  “soft  core,”  and  the  bones  may  be  advantageously 
applied  to  the  sewage  sludge — these  amount  to  5994  per  thousand  tons, 
or  of  the  total  garbage. 

In  a  town  of  10,000  population,  with  a  complete  system  of  garbage 
collection,  there  will  be.  according  to  the  above  data,  2,500  tons  of  gar¬ 
bage  annually,  of  which  1,500  tons  would  be  available  for  mixing  with 
sewage  sludge,  and  1,000  tons  to  be  disposed  of  otherwise;  but  of  this 
1,000  tons,  it  will  be  observed  that  there  remains  but  177$  tons  of  “  soft 
core,”  and  lOf  tons  of  rags  to  be  necessarily  destroyed— a  total  of  188 


LII 


APPENDIX. 


tons,  leaving  7334  tons  of  available  fuel.  In  such  a  town  entirely  sew¬ 
ered,  we  would  have  approximately  600,000  tons  of  sewage  annually; 
from  it  would  be  obtained  6.000  tons  of  precipitated  sludge;  of  this 
there  would  be  5,400  tons  of  liquid  and  600  tons  of  solid  matter.  Adding 
to  the  sludge  the  1,500  tons  of  absorbents  available  from  the  garbage 
and  400  tons  of  ashes  resulting  from  burning  the  911  tons  of  cinders,  coal, 
soft  core  and  rags  would  change  the  sludge  to  a  mixture  of  3,500  tons  of 
solid  and  5,400  tons  of  liquid.  To  raise  this  liquid  from  a  mean  tempera¬ 
ture  of  50°  to  evaporation  would  require  1,719,600,000  heat  units;  but 
assuming  the  cinders  to  have  one-third  of  the  thermal  units  available 
from  the  same  weight  of  coal  in  an  ordinary  steam  boiler  and  furnace, 
we  may  obtain,  by  means  of  a  small  furnace,  from  the  911  tons  of  cin¬ 
ders,  etc..  4,318,000,000  heat  units,  or  3£  times  the  amount  required  to 
completely  dry  the  sludge  and  render  it  a  desirable  form  of  poudrette. 

The  commercial  value  of  this  poudrette  may  be  obtained  as  follows: 
Of  the  $33,500  worth  of  manorial  matters,  above  shown  to  be  contained 
in  the  sewage,  at  least  one  half  may  be  retained  in  the  precipitate  and 
in  the  poudrette,  amounting  to  $4.50  per  ton;  the  garbage  additions,  con¬ 
sisting  of  slaughter  house  refuse,  ashes,  animal  and  vegetable  matters, 
bones,  etc.,  will  increase  the  value  to  $4.75,  making  the  value  of  the 
3,500  tons  of  poudrette  $11,875. 

The  cost  of  reducing  the  sewage  to  6,000  tons  of  sludge  by  precipita¬ 
tion  and  further  reducing  this  to  a  portable  manure  by  means  of  the 
“  filter  press ”  and  heat  would  be  $5,000;  the  cost  of  similar  reduction 
by  the  method  above  outlined  would  probably  be  very  much  less;  but, 
to  be  on  the  safe  side,  I  will  estimate  it  the  same.  The  cost  of  collecting 
and  hauling  the  garbage,  at  fifty  cents  per  ton,  would  be  $1,350,  the 
cost  of  burning  the  188  tons  of  garbage  would  be  $50,  making  the  total 
cost  of  producing  the  3,500  tons  of  poudrette  $6,300 — giving  a  profit 
from  the  works  of  $5,575  per  10,000  population. 

Now,  this  profit,  capitalized  at  five  per  cent.,  gives  $111,500 — an 
amount  generally  sufficient  to  meet  the  cost  of  the  sewerage  system  per 
10,000  population  and  to  provide  several  public  conveniences  in  the 
poorer  quarters  of  the  municipality. 

Further,  it  should  be  observed  that  we  have  remaining  in  the  sewage 
effluent  $11,500  worth  of  manure,  most  of  which  may  be  profitably 
utilized  by  irrigation  on  land,  and  at  the  same  time  very  completely  dis¬ 
posed  of. 

That  the  above  plan,  necessarily  but  briefly  and  generally  outlined,  is 
capable  of  a  very  wide  application,  must  be  apparent;  let  us  summarize 
and  note  its  broad  accomplishments. 

We  have  both  sewage  and  garbage  at  a  point  wherefrom  the  health  of 
the  town  cannot  be  endangered.  We  have  the  sewage  deodorized  in 
precipitation.  We  have  all  the  putrescent  suspended  and  much  of  the 
dissolved  impurities  retained  in  the  sludge,  including  most  of  the  putres- 


APPENDIX. 


LIII 


cible  animal  organisms.  We  have  the  sewage  sludge  transformed  to  a 
condition  of  easy  utility  and  in  a  ready  condition  to  be  utilized  and  puri¬ 
fied  in  the  soil.  We  have  a  thorough  and  systematic  removal  of  both 
sewage  and  garbage — its  complete  disposal  without  creating  a  nuisance. 
What  more  can  be  desired  from  a  sanitary  standpoint  ?  It  is  complete. 
From  an  economic  standpoint  the  same,  whereas  we  see  from  the  above 
careful  and  authentic  calculations  that  the  whole  system,  under  favora¬ 
ble  circumstances,  may  be  made  self-sustaining. 

That  this  seems,  upon  its  face,  incredulous,  I  freely  admit;  and  further, 
I  admit  that  it  surpasses  the  best  results  that  have  ever  been  accom¬ 
plished  m  practice.  But  no  system  has  ever  been  practiced  upon  this 
line  with  any  such  completeness  as  is  herein  contemplated.  Yet.  when 
we  consider  that  while  the  energy  in  nature  cannot  be  either  increased 
nor  lessened,  the  animal  kingdom,  by  its  reproductive  power,  is  con¬ 
stantly  increasing  the  energy  of  its  kind,  is  it  unreasonable  to  suppose 
that  the  vegetable  kingdom  has  a  similar  capacity?  Man  dies  and  is 
consumed  by  worms  and  growing  plants,  yet  the  energy  of  man  is 
increased  by  the  natural  increase  of  man.  Plants  die  and  are  consumed 
by  man  and  other  animals,  but  the  energy  of  plants  is  increased  by  the 
multiplicity  of  their  reproductive  power.  A  grain  of  corn  or  wheat 
planted  in  the  soil  is  reproduced  in  an  hundred  fold.  The  acorns  from 
one  tree  will  bring  forth  hundreds  of  trees.  Likewise  the  few  pounds 
af  ammonia,  potash,  phosphoric  acid,  etc.,  in  the  sewage  and  garbage 
of  any  community,  when  placed  in  the  soil,  will  reproduce  plant-life  in 
great  multiplicity.  Considering  this,  then,  the  aspect  of  incredulity  dis¬ 
appears,  in  that  the  system  contemplates  the  reproductive  application  in 
the  soil  of  all  the  waste  products  of  the  community. 

That  the  system  is  sanitary ,  I  can  see  nothing  to  the  contrary.  That 
it  is,  further,  economical ,  is  shown  wherein  its  operation  may  be  made 
at  least  self-sustaining. 

Since  the  subject  of  garbage  cremation  is  to  be  presented  by  one* 
much  more  able  to  handle  it  than  myself,  I  conclude  to  forego  its  con¬ 
sideration  in  this  paper. 


*  Dr.  Thomas  F.  Wood,  Secretary  N.  C.  Board  of  Health. 


F-' 

D 


LIV 


APPENDIX. 


THE  DUTIES  AND  RESPONSIBILITIES  OF  COUNTY  SUPERIN¬ 
TENDENTS  OF  HEALTH. 


By  J.  L.  Tucker,  M.  D. ,  Member  of  N.  C.  Board  of  Health. 


Dr.  Mapother,  in  his  “  Lectures  on  Public  Health,”  defines  “  Hygiene 
or  Sanitary  Science  ”  to  be  “  an  application  of  the  laws  of  physiology 
and  general  pathology  to  the  maintenance  of  the  health  and  life  of 
communities  by  means  of  those  agencies  which  are  in  common  and 
constant  use.”  The  law,  recognizing  the  utility  of  a  science  thus  defined, 
gives  to  the  several  counties  m  this  State  local  boards  of  health,  whose 
executive  officers  are  to  be  chosen  from  the  physicians  legally  qualified 
to  practice,  and  are  to  be  known  as  County  Superintendents  of  Health. 
The  “  Duties  and  Responsibilities”  appertaining  to  this  office  are  sub¬ 
jects  to  which  I  would  ask  your  brief  attention. 

The  act  regulating  the  duties  of  this  important  office  may  be  briefly 
summarized: 

It  shall  be  his  duty  to  collect  vital  statistics,  to  make  medico-legal 
post-mortem  examinations  for  coroners’  inquests,  to  attend  prisoners  in 
jail,  poor-house  and  house  of  correction,  and  to  make  examination  of 
lunatics  for  commitment.  He  shall  be  the  sanitary  inspector  of  the  jail 
and  poor-house  of  his  county,  making  monthly  statements  to  the  board 
of  commissioners.  The  duties  are  further  enlarged  and  the  responsi¬ 
bilities  increased  so  as  to  bring,  with  the  advice  of  the  local  board  of 
health,  the  important  matter  of  inland  quarantine  under  his  control. 
Diseases  dangerous  to  public  health,  viz.,  small  pox,  scarlet  fever, 
yellow  fever,  and  cholera,  are  to  be  quarantined  and  isolated  at  the 
expense  of  the  county,  town  or  city  in  which  they  occur.  It  shall  be 
his  duty  to  abate  nuisances;  and  finally,  the  important  matter  of  vacci¬ 
nation  is  committed  to  his  care. 

The  field  thus  outlined  is  broad  enough,  and  the  soil  sufficiently  fertile 
to  invite  occupancy,  with  a  promise  of  a  rich  harvest,  not  alone  to  the 
physician  and  sanitarian,  but  as  well  to  the  philanthropist  and  public- 
spirited  citizen. 

The  system  of  medical  and  sanitary  inspection,  as  applied  to  our  jails, 
almshouses  and  houses  of  correction,  has  already  yielded  fruits  of  a 
most  gratifying  character,  and  the  increased  interest  this  matter  is 
receiving  at  the  hands  of  our  superintendents,  in  more  detailed  reports 
to  the  Monthly  Bulletin ,  promises  still  greater  results,  which,  from  the 
very  nature  of  the  work,  must  commend  it  to  the  support  of  all  good 
people  throughout  the  State.  But  unfortunately,  many  of  our  counties 
are  without  health  boards,  and  their  public  institutions  are  left  without 
the  care  and  superintendence  of  health  officers. 


APPENDIX. 


LV 


It  is  almost  incredible  in  this  enlightened  age,  in  which  all  the  lines 
of  ait  and  science  aie  advanced  an  age  so  prolific  of  good  works — that 
there  should  be  a  penal  institution  or  a  house  of  alms  in  the  State  in 
which  the  inmates  aie  denied  the  blessings  of  sunlight,  pure  air  and 
wholesome  food;  and  yet,  sickening  and  revolting  as  the  recital  is,  such 
enoimities  aie  being  constantly  brought  to  the  notice  of  the  medical 
profession,  some  of  whose  members  have  been  prompt,  in  language 
caustic  and  eloquent,  to  expose  and  denounce  these  cruelties.  It  has 
been  but  a  short  while  since  a  distinguished*  President  of  the  North 
Carolina  Medical  Society,  in  his  annual  message  to  that  body,  directed 
public  attention  to  this  matter.  Describing  his  visit  to  a  North  Carolina 
city ,  ^  her e  lie  found  a  singular  blending  of  “wealth  and  religion,’ 
piety  and  sin,  in  a  city  partly  noted  for  the  culture,  elegance  and  refine¬ 
ment  of  her  citizens,  he  thus  describes  his  visit  to  the  jail:  “Inside  an 
encircling  brick  wall,  pierced  by  two  small  windows,  was  an  iron  cage, 
twelve  feet  square  and  twelve  feet  high;  the  cage  was  divided  by  one 
iron  floor  into  two  stories;  each  of  these  was  subdivided  into  two  cells 
and  a  passage-way.  After  my  eyes  had  become  accustomed  to  the  dim 
light,  I  counted  twenty-four  human  beings  huddled  in  these  confined 
quarters.  They  were  clothed  in  rags,  and  a  few  tattered  pieces  of 
blankets  and  sacks  constituted  their  bedding.  Many  of  these  poor 
wretches  had  laid  there  for  many  months  awaiting  trial  for  petty 
offences.  The  place  was  reeking  with  filth,  and  the  stench  was  beyond 
description.  Every  sanitary  necessity  was  absent.” 

Other  gentlemen,  in  language  no  less  pungent,  have  directed  attention 
to  these  foul  blots  upon  our  civilization,  and  to  our  county  superin¬ 
tendents  of  health  belongs  the  duty  of  redressing  the  wrongs.  Let  it 
not  for  a  moment  be  supposed  that  our  superintendents  will  fail  in  their 
duty.  Frequent  inspections,  with  detailed  statements  to  the  county 
commissioners,  and  given  to  the  public  through  the  Monthly  Bulletin , 
setting  forth  the  sanitary  need  of  each  and  every  public  building,  with 
suggestions  as  to  the  hygienic  needs  of  the  inmates,  will  arouse  a  senti¬ 
ment  in  the  counties  which  officials  dare  not  oppose.  Failing  in  this, 
let  us  take  the  matter  to  our  grand  juries,  and  in  official  capacity  deliver 
them  homilies  on  public  hygiene,  setting  forth  the  dangers  of  overcrowd¬ 
ing,  foul  air,  impure  water,  and  unwholesome  food,  and,  in  the  name  of 
a  common  civilization,  demand  an  abatement  of  these  nuisances.  The 
need  of  greater  oversight  upon  the  one  thousand  resident  insane  in  the 
several  counties  cannot  be  too  strongly  emphasized.  A  register  setting 
forth  age,  residence,  cause  and  type  of  insanity,  with  frequent  reports  to 
the  county  commissioners  as  regards  conditions,  wants  and  needs  of  these 
people,  will  go  far  towards  securing  for  them  the  care  and  treatment 
which  an  enlightened  and  civilized  people  are  expected  to  bestow  on  the 


*  Dr.  H.  T.  Bahnson,  meeting  of  Medical  Society  at  Charlotte,  1888. 


LVI 


APPENDIX. 


ignorant,  helpless  and  unfortunate.  These  questions  involve  grave 
responsibilities,  and  are  important  enough  to  command  the  best  executive 
ability  and  the  profoundest  medical  and  sanitary  knowledge. 

Let  it  not  be  said,  as  has  been  said  recently  by  a  distinguished  alienist,* 
that  “those  under  county  care  are  daily  passing  downward,  by  steady 
stages,  to  the  level  of  hopeless  alienation  in  such  accumulating  numbers 
that  humanity  sickens  at  the  conception,  both  at  what  they  endure  now 
and  what  life  has  in  store  for  them,  and  all  who  hold  them  dear.”  Let 
us  urge  upon  our  county  commissioners  the  need  of  better  facilities  at 
our  almshouses  for  the  care  and  treatment  of  the  insane,  especially  for 
those  who  are  awaiting  commitment  into  the  asylums  of  the  State,  and 
as  far  as  possible,  let  us  use  our  efforts  to  ameliorate  their  conditions. 
Earnest,  intelligent  and  brave  endeavor  on  the  part  of  our  superin¬ 
tendents  will  remove  present  evils. 

There  are  other  fields  to  which  the  labors  of  our  health  officers  can  be 
profitably  carried.  The  subject  of  public  school  education,  to  which  the 
masses  of  our  people  are  looking  with  so  much  interest,  and  the  impetus 
which  this  important  work  will  receive  by  the  passage  of  the  Blair  bill, 
now  pending  before  the  National  Congress,  must  render  the  matter  of 
school  inspection,  by  competent  and  trained  sanitarians,  of  paramount 
importance.  We  are  fast  getting  away  from  the  traditional  log  school- 
house,  with  its  open  crevices,  its  large  chimney  and  its  roaring  fire,  and 
in  its  place  we  are  substituting  frame  buildings,  tightly  ceiled,  with  all 
possible  defects  of  ventilation,  and  heated  by  that  greatest  curse  of  the 
age — the  modern  stove.  To-day,  in  many  of  the  rural  districts,  we  have 
a  number  of  school  buildings,  twenty  feet  square  and  ten  feet  pitch, 
giving  a  total  air  space  of  about  4,000  cubic  feet,  in  which  forty  pupils 
are  being  taught — just  a  little  over  100  feet  per  capita  of  air  space,  and 
with  no  other  method  of  air  displacemeut,  except  through  a  raised 
window  or  open  door,  the  temperature  at  one  moment  sending  the 
mercury  to  the  roasting  point  and  in  the  next  lowering  it  to  freezing. 
What  an  admirable  opportunity  is  here  offered  to  the  medical  expert  in 
the  study  of  the  causative  effect  of  foul  air,  cold  draughts  and  varying 
temperature  in  the  production  of  winter  catarrhs,  to  say  nothing  of  the 
more  serious  lesions  of  pleurisy  and  pneumonia;  and  what  a  volume  of 
interesting  facts  might  be  gathered  in  the  study  of  the  personal  history 
of  each  individual  pupil,  as  regards  the  development  of  pulmonary 
consumption,  or  the  long  list  of  nervous  ailments  which  neurologists 
trace  directly  to  such  influences.  It  can  scarcely  be  expected  that  a 
costly  and  cumbrous  system  of  inspection  should  be  given  in  the  present 
development  of  our  school  system.  But  as  physicians  and  sanitarians, 
we  can  properly  and  profitably  advise  as  to  the  location,  size  and 
arrangement  of  these  buildings,  grounds,  drainage  and  water  supply; 


*  Eugene  Grissom,  M.  D.,  LL.  D.,  report  Raleigh  Insane  Asylum. 


APPENDIX. 


LVII 


methods  of  supplying  sunlight,  so  as  to  minimize  dangers  to  the  eyes; 
furniture  (seats  and  desks)  adapted  to  all  ages  and  sizes,  and  at  the  same 
time  direct  attention  to  the  more  salient  points  of  danger  to  the  health 
of  the  inmates. 

In  illustration  of  this  point,  I  will  mention  that  a  few  years  ago,  in  the 
county  of  Vance,  near  the  village  of  Townesville,  an  epidemic  of  typhoid 
fever  occurred  in  the  neighborhood  school.  There  were  more  than  ten 
cases  (cannot  be  accurate  as  to  numbers)  in  an  enrolled  school  of  about 
twenty-eight  pupils.  Dr.  Wm.  R.  Wilson,  a  most  competent  and  skillful 
physician  and  sanitarian,  failing,  after  a  most  vigorous  search,  to  find 
any  possible  cause  for  the  epidemic  in  the  several  homes  of  the  pupils, 
carried  his  investigations  to  the  school  premises.  Here  he  learned  that 
many  of  the  .  upils  had  suffered  during  the  year  from  diarrhoea,  dysen¬ 
tery  and  other  ailments,  and  that  the  session  had  been  unprofitable  to 
scholar  and  teacher  alike.  An  examination  of  the  surroundings  disclosed 
a  polluted  spring  as  the  source  of  contagion.  The  ground  overlying  the 
spring  was  covered  with  undergrowth,  and  had  been  used  by  the  school 
for  months  as  a  “privy  walk,”  and  here  we  had  soil  saturation,  or 
possibly  excretal  washings  direct,  water  pollution,  and.  as  a  necessary 
consequence,  that  disease  of  filth,  typhoid  fever.  The  nuisance  was 
abated,  a  new  supply  of  water  secured,  the  epidemic  stopped,  and  Dr. 
Wilson  ever  afterwards  became  a  most  active  and  zealous  advocate  of 
preventive  medicine.  It  is  a  source  of  real  regret  that  another  State  is 
to-day  receiving  the  labor  and  teachings  of  this  faithful  and  accom¬ 
plished  physician,  whose  first  interest  in  public  hygiene  dates  from  this 
little  incident.  Doubtless,  similar  instances  might  be  reported  from 
other  portions  of  the  State,  all  calling,  more  eloquently  than  words,  for 
medical  and  sanitary  inspection. 

Let  us  urge  our  superintendents  to  give  to  each  and  every  school  in 
their  respective  counties  one  careful  and  thorough  inspection  annually, 
and  to  file  with  the  Superintendent  of  Instruction  a  report  of  the  same, 
setting  forth  clearly  whatever  suggestions  may  appear  necessary  to 
promote  the  health  and  comfort  of  the  school. 

The  subject  of  vaccination  in  our  public  schools  should  address  itself 
more  to  our  superintendents  of  health.  I  cannot,  in  the  limits  of  this 
paper,  recount  the  many  arguments  in  favor  of  vaccination,  and,  indeed, 
to  physicians  such  arguments  are  unnecessary;  but  as  we  are  honored 
to-day  by  the  presence  of  so  many  distinguished  laymen,  I  hope  I  will 
be  pardoned  for  recalling  the  well  authenticated  immunity  enjoyed  by 
the  German  army  in  the  Franco-Prussian  war. 

The  Germans  never  do  things  by  halves.  They  believe  in  preventi\e 
medicine,  and  practice  it  in  its  highest  and  fullest  sense,  and  in  nothing 
is  the  strength  of  this  proposition  more  beautifully  exemplified  than  in 
the  matter  of  vaccination.  By  statutory  provision  every  infant  is 
required  to  be  vaccinated  before  it  attains  the  age  of  one  year;  the  child 


LV1II 


APPENDIX. 


is  revaccinated  at  twelve,  and  the  subject  who  comes  to  discharge  his 
military  obligation  to  the  sovereign  is  again  re  vaccinated,  the  operation 
being  repeated  until  the  surgeon  is  satisfied  that  the  person  is  insus¬ 
ceptible  to  vaccinia.  The  German  army  may,  therefore,  be  regarded  as 
a  thoroughly  vaccinated  body  of  men.  In  France,  on  the  other  hand, 
vaccination  and  revaccination  is  not  compulsory;  perhaps  it  is  done  or 
not,  as  the  danger  of  an  epidemic  may  determine.  During  the  war 
small  pox  prevailed  to  an  alarming  extent,  and  both  armies  were  equally 
exposed  to  the  contagion,  with  the  following  results:  The  French  army, 
scarcely  more  than  one-half  the  strength  of  the  German,  suffered  the 
frightful  mortality  of  23,468  from  small-pox,  while  the  German  army 
suffered  the  insignificant  loss  of  263  men. 

Another  instance,  quite  as  convincing,  may  be  cited  of  Zurich,  Swit¬ 
zerland.  With  a  compulsory  vaccination  law  in  force  small-pox  was 
entirely  stamped  out,  and  for  years  was  unknown;  and  yet,  in  three 
years  after  the  repeal  of  the  law,  the  death-rate  shows  85  from  small-pox 
in  1,000  deaths  from  all  causes,  or  about  one- twelfth  of  all  deaths  were 
from  small-pox.  Can  any  sane  person  require  stronger  proof  of  the 
prophylactic  power  of  vaccination  against  small-pox? 

The  immunity  enjoyed  by  our  State  for  the  past  two  decades  from 
small-pox  epidemics  has  lulled  the  people  into  a  state  of  security  utterly 
unwarranted  by  the  history  of  the  disease.  Of  the  nineteen  hundred 
and  fifteen  persons  committed  to  the  jails,  as  reported  to  the  Bulletin 
for  the  past  six  months,  only  three  hundred  and  seventy-three  give 
evidence  of  successful  vaccination — about  one  in  five.  A  conservative 
estimate  would  place  more  than  four  hundred  thousand  of  our  people 
without  this  great  prophylactic,  and  it  is  high  time  the  importance  of 
this  matter  was  being  pressed  upon  the  attention  of  health  officer,  physi¬ 
cian  and  the  general  public. 

The  advancement  of  public  hygiene  in  this  country  for  the  past  twenty 
years  has  been  due  largely  to  the  increased  attention  given  by  the  State 
and  county  boards  of  health  to  the  collection,  preservation,  classification 
and  publication  of  vital  statistics. 

The  chief  statistics  bearing  on  public  health  are  of  deaths,  births  and 
marriages.  With  these  reports  should  be  bulletins  announcing  all 
diseases  dangerous  to  public  health — especially  those  of  an  epidemic 
character.  There  are  few  persons  who  will  question  the  value  of  such 
statistics,  not  alone  to  physicians  and  sanitarians,  but  as  well  to  politi¬ 
cians,  legislators,  business  men,  and  the  citizens  at  large.  Without  a 
knowledge  of  the  number  of  persons  dying,  the  locality  and  cause  of 
such  deaths,  it  is  impossible  to  know  when  sanitary  remedies  are  needed, 
or,  indeed,  what  remedies  are  to  be  applied.  Without  a  comparison  of 
the  death  and  birth  rate,  it  is  impossible  to  form  an  idea  of  the  “  ebb  or 
flow  of  the  tide  of  human  life.”  or  as  Dr.  Billings  so  strongly  expresses 
it:  “Protection  to  public  health  cannot  be  given  wisely  without  a 


APPENDIX. 


LIX 


knowledge  of  the  persons  and  places  who  stand  most  in  need  of  it,  and 
this  knowledge  can  only  be  obtained  by  a  systematic,  complete  and 
continued  registration  of  the  births  and  deaths  in  every  community  of 
the  State.  Such  registration  is,  as  it  were,  the  eyes  of  the  State  Board  of 
Health,  and  without  it  the  board  is  like  a  blind  man  fighting  a  prairie 
fire.”  The  statistics  already  collected  in  this  State  are  suggestive,  but 
are  too  meagre  to  admit  of  much  valuable  discussion.  We  are  behind 
other  States  in  this  important  matter,  and  few  questions  can  engage 
your  attention  to-day  more  profitably. 

Without  suggesting  a  plan  by  which  this  important  branch  of  the 
service  can  be  perfected,  I  can  express  the  belief  that  “  where  there  is  a 
will  there  is  a  way.”  Different  States  have  different  plans — some  better 
than  others,  but  none  are  perfect.  No  one  at  all  acquainted  with  the 
workings  of  the  North  Carolina  Health  Board  will,  for  a  moment,  doubt 
that  the  genius  and  wisdom  of  her  executive  officer  will  bring  “order 
out  of  chaos,”  and,  in  the  near  future,  unfold  to  us  the  details  of  a  plan 
that  will  secure  to  us  complete  and  accurate  returns  of  births,  deaths 
and  marriages  in  every  city,  town  and  county  in  the  State.  With  such 
statistics,  the  board  will  demonstrate  to  you  what  sanitary  science, 
practically  applied,  is  capable  of  accomplishing,  and  that  it  is  not,  as  has 
been  said,  “a  mere  jumble  of  unproved  hypotheses.” 

The  present  law  under  which  our  statistics  are  collected  displays  its 
weakness  in  its  great  elasticity.  An  amendment  here  and  there  of  a 
primitive  character,  to  bear  equally  upon  superintendents,  county 
officials,  doctors,  midwives,  undertakers,  and  the  heads  of  families,  will 
have  a  most  salutary  effect  in  removing  existing  evils.  But  the  question 
may  be  pertinently  asked:  What  are  you  going  to  give  in  return  for 
such  exactions  from  doctors,  county  officials,  and  the  people  at  large? 
The  answer  is  simple.  If  we  were  to  apply  the  money  test  as  to  the 
value  of  the  life  of  each  citizen  who  dies  from  a  preventable  disease,  as 
suggested  by  Dr.  Farr,  and  corroborated  by  the  veteran  sanitarian, 
Edwin  Shadwick,  of  England,  it  would  make  a  sum  so  large  that  capi¬ 
talists  would  be  startled.  It  is  enough  for  us  to  say  that  the  amount 
saved  to  the  State,  as  thus  demonstrated,  is  so  enormous  that  the  most 
visionary  dreams  of  speculation  can  offer  nothing  so  alluring.  But  this 
is  the  weaker  side  of  the  question. 

In  return  we  promise  diminished  sickness,  improved  health,  increased 
longevity,  and  the  resultant  blessings  of  happy  and  cheerful  homes  for 
every  man,  woman  and  child  in  North  Carolina.  “With  decreasing 
mortality  there  comes  increasing  longevity.  Statisticians  tell  us  that 
the  duration  of  human  life  has  been  advanced  from  twenty-eight  and 
below  to  forty- one  years  under  the  ordinary  workings  of  sanitar\  law, 
and  that  if  mortality  can  be  reduced  to  fifteen  per  thousand,  and  main¬ 
tained  at  that  figure,  that  the  rate  will  be  advanced  to  fifty-four  yeais, 
and  if  we  can  reach  eight  per  t  housand,  as  suggested  by  the  distinguishe 


LX 


APPENDIX. 


Dr.  Richardson,  in  his  beautiful  picture  of  the  ideal  City  of  Hygeia,  with 
her  broad  streets,  lovely  courts  and  faultless  drains,  her  extended  parks 
and  silvery  lakes  and  pure  water,  it  will  carry  it  up  towards  ninety. 

The  application  of  sound  sanitary  laws,  as  applied  to  the  military  forces 
in  England,  notably  to  the  Royal  Guards,  shows  a  reduction  of  twenty 
per  thousand  to  six  and  five  tenths,  and  under  more  rigid  enforcement 
in  the  German  army  the  rate  has  been  lowered  to  only  five  per  thousand, 
with  almost  a  total  exemption  from  dysentery, 'diarrhoea,  typhus  and 
typhoid  fever.  And  so  in  England  and  Wales,  statistics,  as  applied  to 
the  people  at  large,  show  a  reduction  of  the  death-rate  from  forty  per 
thousand  to  twenty,  and  in  localities  where  sanitary  details  are  practi¬ 
cally  and  systematically  administered,  even  as  low  as  fifteen  per  thou¬ 
sand.  Similar  results  can  be  obtained  in  this  country — in  our  own  Stafte 
and  for  our  own  people;  and,  as  guardians  of  the  public  health,  charged 
with  the  sacred  trust  of  saving  human  life  and  lessening  human  suffer¬ 
ing,  we  should  press  the  importance  of  these  matters  upon  the  people 
and  arouse  a  sentiment  commensurate  with  the  great  interests  involved. 

Lord  Derby,  years  ago,  felt  the  need  of  popular  aid  in  solving  the 
problem  of  public  hygiene,  when  he  declared  that  “  no  sanitary  improve¬ 
ment  worth  the  name  will  be  effective,  whatever  acts  you  pass  or  what¬ 
ever  powers  you  confer  on  public  officers,  unless  you  create  an  intelligent 
interest  in  the  matter  among  the  people  at  large.” 

Let  our  county  superintendents  of  health  take  this  great  lesson  to 
heart,  and,  in  all  matters  affecting  public  health,  let  them  assume  leader¬ 
ship  and  teach  the  people  the  great  benefits  and  blessings  that  follow 
when  sanitary  laws  are  wisely  administered. 


APPENDIX. 


LX  I 


SOME  GAINS  FROM  SANITATION. 


By  J.  W.  Jones,  M.  D.,  President  N.  C.  Board  of  Health. 


Advance  in  civilization  is  founded  on  enlightened  self-interest.  The 
people  have  a  right  to  protest  against  any  demands  on  them  unless  there 
be  promise  of  profitable  returns,  and  to  demand  of  the  government  the 
protection  of  their  lives,  their  health,  and  their  fortunes. 

The  real  health  of  a  people  is  not  counted  by  its  gold,  silver  and  acres. 
These  are  sources  of  material  and  physical  greatness;  above  these,  as 
high  as  the  heaven  is  above  the  earth,  as  a  simpler  question  of  value,  is 
the  health  of  the  people.  Here  is  the  manhood,  the  real  civilization,  the 
source  of  its  content,  happiness,  and  its  good  will  to  men. 

The  best  interest  of  the  State  is  absolutely  dependent  on  the  family 
relation,  and  these  on  the  godliness,  good  order,  and  clean,  ine-s  of  the 
individual.  The  greater  part  of  the  wealth  of  a  nation  is  'hat  income 
which  is  the  outcome  of  national  health.  Public  health,  hen,  should 
be,  as  Lord  Beaconsfield  years  ago  expressed  it,  of  the  first  c»  nsideration 
to  the  State,  and  should  have  the  first  care  of  the  statesman .  The  pros¬ 
perity  of  the  State  is  the  aggregate  of  the  average  prosperity  of  its  citizens, 
and  every  increase  of  individual  prosperity,  every  dollar  earned  by  the 
citizen,  is  so  much  earned  for  the  State;  or,  every  detracti  >n  from  the 
individual  prosperity,  of  his  time,  or  his  money,  or  even  his  life,  is  so 
much  taken  from  the  State’s  social  capital.  And  equally  true  is  it,  that 
all  a  man  earns  over  enough  for  his  living  is  so  much  added  to  the  public 
capital;  or  that  his  living  cost  more  from  any  cause  than  his  earnings, 
that  deficit  is  that  much  loss  to  the  commonwealth;  so,  then,  in  the  case 
of  the  premature  death  of  a  productive  individual,  his  death  is  a  with¬ 
drawal  of  so  much  productive  industry  from  the  State;  or,  in  case  of  his 
sickness,  the  suspension  of  such  income  as  that  would  come  from  his 
labors  if  he  were  in  good  health.  And  so  it  follows,  that  as  to  man  s 
ability  to  make  available  the  forces  of  nature  and  the  resources  of  the 
country,  will  be  the  value  of  the  lands,  and  that  any  detraction  from  the 
citizen’s  ability  is  that  detraction  from  the  land’s  value. 

Mr.  Farr  estimates  the  value  of  a  Norfolk  agricultural  laborer  at  £246, 
and  that  of  a  professional  man  at  £300.  In  that  of  a  minor  it  is  the 
deferred  annuity  which  represents  the  probable  earnings  of  his  manhood, 
minus  the  amount  spent  in  his  maintenance  during  his  unproductive 
childhood.  Taking  the  relations  of  the  different  ages,  their  occupations 
and  conditions,  he  has  undertaken  the  laborious  task  of  averaging  these 
various  factors  to  reach  the  mean  value  of  the  individual.  Fiom  the 
statistics  furnished  him  by  the  English  Government,  he  makes  the 
approximate  minimum  inherent  money  value  in  the  U  nited  Kingdom  of 
every  man,  woman  and  child  at  £159,  or  !s79o.  a  head.  In  the  United 


LXII 


APPENDIX. 


States,  under  conditions  of  higher  interest  and  wages,  on  Mr.  Farr’s  esti¬ 
mates,  his  money  value  is  put  at  $1,000,  but  more  than  this  by  some. 

Vital  statistics  are  made  up  from  the  reports  of  deaths,  births,  mar¬ 
riages,  diseases  and  any  other  matter  that  pertains  to  the  health  of  a 
people.  Tlic present  value  of  a  person  is  his  future  earnings,  minus  his 
necessary  outgo  in  realizing  these  earnings. 

From  a  study  of  carefully  kept  vital  statistics,  and  tables  of  present 
values  of  annuities,  the  health  and  wealth  of  a  country  can  be  calculated 
with  great  accuracy. 

If  the  present  value  of  a  person  is  $500  a  year,  and  that  person  dies 
twenty  years  sooner  than  the  natural  termination  of  the  life  of  a  healthy 
working  life-time,  the  loss  to  the  community  is  the  present  value  of  the 
annuity  of  $500,  with  the  interest  for  twrenty  years;  or,  if  he  should  be 
sick,  the  cost  of  the  lost  time  is  a  withdrawal  of  so  much  from  the  public 
capital,  together  with  the  cost  of  his  living,  nursing,  medical  attention, 
and  medicine  during  his  illness. 

The  advances  made  in  the  arts  and  sciences,  the  incidents  of  war,  and 
the  destruction  of  life  by  disease  in  the  great  armies  of  the  world,  and 
the  great  epidemics,  first  led  the  way  to  the  study  of  sanitation.  The 
appalling  disaster  by  disease  in  the  last  Crimean  campaign  has  been 
turned  into  a  victory  to  military  sanitary  science.  The  ravages  of  typhus 
fever  in  badly  ventilated  shipholds  and  prisons  attracted  the  attention 
of  the  philanthropist,  John  Howard,  and  led  sanitary  physicians  to 
look  to  the  construction  of  buildings  in  regard  to  disease.  The  pale 
faces  and  unsteady  walk  of  the  operatives,  doomed  to  live  in  the  badly 
ventilated  and  badly  lighted  houses  and  factories,  was  everywhere  seen. 
So  much  had  the  public  mind  become  impressed  by  these  conditions, 
that  in  1802  England  manifested  her  recognition  of  the  needed  sanitary 
reform  by  the  passage  of  a  series  of  legislative  acts  for  the  whole  king¬ 
dom.  This  was  the  beginning  of  our  present  system  of  State  medicine. 

In  1847  Mr.  Chadwick  made  his  great  report  to  the  Government  “on 
the  sanitary  condition  of  the  laboring  classes,”  and  so  great  was  the 
impression  made  by  this  report  that  it  resulted  in  the  revising  of  the  old 
poor  law  which  had  been  in  existence  ever  since  the  reign  of  Elizabeth, 
and  had  grown  to  be  a  burden  instead  of  a  relief  to  the  poor.  This  revi¬ 
sion  has  served  as  a  foundation  and  a  guide,  not  only  for  England,  but 
for  all  other  enlightened  nations  as  well,  and  from  its  date  preventive 
medicine  became  a  distinct  branch  of  learning.  To-day  every  enlightened 
government  has  its  health  department,  nearly  every  State  in  our  Union 
has  its  State  and  local  boards  of  health,  and  in  most  of  our  schools  and 
universities  sanitary  science  is  taught  as  a  part  of  the  course  of  instruc¬ 
tion.  Where  sanitary  science  has  been  taught,  and  its  regulations 
applied,  there  has  been  a  corresponding  lowering  of  the  sick  and  death 
rates. 


APPENDIX. 


LXIII 


To  the  question,  “  What  are  some  of  the  gains  by  sanitation  we 
shall  pass  a  reference  to  the  sentiments  of  grief  for  the  dead  that  should 
not  have  died,  and  to  the  sick  that  should  not  have  been  sick,  and  the 
joys  for  the  saved  from  death  and  sickness,  and  reply  only  to  that  part 
of  the  question  that  can  be  answered  in  the  language  of  figures. 

Before  the  flood  the  average  length  of  life  was  between  700  and  800 
years.  After  the  flood  it  gradually  fell  till  it  went  down  to  18  or  20 
years;  as  learning  revived,  length  of  life  increased.  At  the  time  of  the 
beginning  of  the  sanitary  reform  it  was  about  27  in  England.  At  this 
time  it  is  about  45  years. 

The  length  of  life  in  the  reign  of  Victoria  has  increased  10  per  1,000, 
from  35  to  45.  The  government  of  this  great  and  good  Queen  has  ever 
been  a  friend  to  the  reform;  her  Prince  Consort  Albert  was  ever  pleased 
to  promote  it. 

Dr.  McVail,  in  his  presidential  address  before  the  Sanitary  Association 
of  Scotland,  last  year,  said  in  substance,  that  the  death-rate  in  England 
and  Wales  in  1861  was  22.595  per  1,000,  and  in  1885  it  was  19.310  per 
1,000,  and  that  the  reduction  between  the  years  of  1861  and  1885  would 
make  an  annual  saving  in  England  and  Wales,  with  a  population  of 
30,000,000,  of  100,000  lives.  In  American  money,  estimating  each  life  at 
$1,000,  and  20  cases  of  serious  sickness  to  the  death,  at  a  cost  in  lost 
time,  medicine,  doctor’s  bill,  nursing,  food  and  rent  of  $100,  the  saving 
was  annually  $300,000,000;  and  that  the  children  in  one  year  have  now 
divided  among  them  nearly  two  millions  of  years  of  life  more  than 
would  have  been  the  case  thirty-five  years  ago. 

In  London  within  the  last  century  the  death-rate  has  been  reduced 
from  50  to  22  per  1,000,  a  gain  of  28;  in  1884,  that  of  her  contagious 
diseases  from  the  average  of  5.25  to  3.4. 

In  France,  within  this  century,  the  average  length  of  life  has  been 
increased  10  years,  an  aggregate  of  four  hundred  millions  of  years  for 
the  whole  population. 

Mr.  Chadwick,  in  a  paper  on  military  sanitation,  gives  the  following 
rates  of  deaths  and  gains  in  the  great  armies  of  Europe: 

In  the  guards  a  quarter  of  a  century  ago  the  death-rate  was  20  per 
1,000— now  it  is  6£;  while  that  of  the  home  army  was  17  per  1,000, 
reduced  to  8.  The  rate  of  the  whole  English  army,  home  and  abroad, 
is  17.  Germany  has  the  lowest  death-rate  of  any  nation,  namely,  5  oi  6 
per  1,000.  In  France,  it  is  10  per  1,000.  In  Austria,  it  is  11  per  1,000; 
for  the  whole  nation,  32.  In  Italy,  11  per  1,000.  In  Russia,  18  pei  1,000, 
three  times  heavier  than  Germany.  In  these  United  States,  9  pei  1,000, 
the  nation,  19.  The  men  in  the  army  are  healthier  than  the  class  at 
home  from  which  they  were  drawn,  due  to  strictly  applied  sanitary 

regulations. 

The  actual  mortality  of  both  armies  in  the  late  civ  il  \\  ai  fiom  all 
causes,  from  May,  1861,  to  June,  1866,  was  504,369;  killed  in  battle  and 


LX  IV 


APPENDIX. 


died  of  wounds,  143,969;  died  from  sickness,  360,400,  in  both  armies. 
At  this  the  whole  civilized  world  stands  amazed  and  appalled,  and  justly 
so.  It  was  the  work  of  the  demon  of  war,  and  yet  our  annual  loss  of 
life  by  preventable  sickness,  taking  our  population  at  this  time  to  be 
60,000,000,  is  120,000,  almost  equal  annually  to  what  it  was  by  diseases, 
killed  in  battle,  and  died  from  wounds  in  our  late  civil  war  in  both 
armies,  which  was  126,000  annually. 

There  has  been  the  most  extraordinary  gains  by  antisepticism  since 
1880,  when  Pasteur  first  saw  the  microbe  of  puerperal  fever.  It  is  seen 
in  every  department  of  medicine,  but  more  especially  in  obstetrics  and 
surgery.  One  case  will  serve  our  purpose  to-day.  In  La  Maternite, 
Paris,  there  is  a  line  on  the  wall  showing  the  total  death-rate  of  women 
confined  in  that  hospital  from  1792  to  1886.  The  record  is  divided  into 
three  periods;  the  first  that  of  inaction,  in  which  the  mortality  was 
from  9.3  to  20  per  cent.;  the  second,  the  battle  of  hygiene  against  infec¬ 
tion  and  contagion,  with  a  mortality  of  2.3;  and  third,  the  victory  of 
antisepticism,  with  a  mortality  of  less  than  one  per  cent. 

The  gains  from  vaccination  have  been  accumulating  since  the  day  of 
Jenner.  In  Paris,  where  the  laws  requiring  vaccination  are  feebly 
enforced,  the  mortality  from  small-pox  is  from  10  to  136  to  the  1,000; 
while  in  the  German  cities,  where  vaccination  laws  are  enforced,  the 
death-rate  is  but  1.44;  in  London,  under  compulsory  laws,  it  is  but  6  to 
the  1,000;  while  in  parts  of  Switzerland,  it  runs  up  to  8  and  10  to  the 
1,000.  The  possibility  of  protective  inocculation  in  other  diseases  is  yet 
unknown.  There  are  promises  that  in  the  near  future  its  triumphs  will 
be  as  great  in  some  other  diseases  as  it  has  been  in  small-pox. 

Some  years  ago  Messrs.  Simons  and  Chadwick  made  the  estimate  that 
England  and  Wales  lost  annually  200,000  lives  from  preventable  causes; 
France,  250,000;  and  Spain,  190,000.  Mr.  Billings  estimates  the  loss  of 
the  United  States  at  100,000  on  the  census  of  1850.  These  figures  mean, 
that  the  United  States  loses  annually  of  her  citizens  who  should  be 
saved,  100,000,  at  a  money  loss  in  deaths  and  sickness  of  $300,000,000  on 
the  census  of  1850,  counting  the  cost  of  the  dead  at  $1,000  and  each  case 
of  sickness  at  $100. 

North  Carolina,  with  an  estimated  population  of  one  and  one  half 
millions,  has  annually,  from  preventable  sickness,  3,000  deaths  and 
60,000  cases  of  serious  sickness,  at  a  money  loss  of  $3,000,000  for  deaths 
and  $6,000,000  for  sickness.  Total  loss  from  deaths  and  sickness, 
$9,000,000 — a  loss  of  $6  a  head  for  every  man,  woman  and  child.  The 
present  death-rate  of  Raleigh  is  38.4.  Suppose  we  reduce  this  death-rate 
just  one  in  the  1,000  this  year,  we  save  15  lives  and  prevent  300  cases  of 
sickness,  and  save  $45,000.  These  figures  show  that  one  in  every  500 
of  our  population  of  50,000,000,  or  one-fifth  of  one  per  cent.,  die  that 
should  not  die;  and  that  one  in  every  25  of  our  population  are  sick  who 
should  not  be  sick. 


APPENDIX. 


LX  V 


Sir  James  Paget  thinks,  from  estimates  made  from  reliable  data,  from 
reports  of  the  benevolent  and  charitable  institutions  of  England,  that  the 
annual  loss  of  time  in  the  United  Kingdom  is  about  one- fortieth  of  the 
working  time,  or  nine  days  a  year  for  every  man,  woman  and  child 
between  the  ages  of  16  and  65  years. 

We  shall  take  it  that  two-fifths  of  the  people  of  North  Carolina  are 
between  the  ages  of  16  and  65  years;  then  North  Carolina,  with  a  popu¬ 
lation  of  one  and  one-half  millions,  loses  annually  by  sickness  9,000,000 
days’  work,  and  putting  the  cost  of  lost  time,  living  and  nursing  during 
sickness,  medicine  and  medical  bills  at  $2  per  day,  $18,000,000.  Raleigh, 
with  an  estimated  population  of  15,000,  loses  9,000  days’  work,  in  money 
value  $18,000.  The  larger  part  of  these  losses  could  and  should  be  pre¬ 
vented. 


LXVI 


APPENDIX. 


THE  SEWERAGE  OF  CITIES  AND  TOWNS. 


By  J.  L.  Ludlow,  C.  E.,  M.  S.,  Member  North  Carolina  Board  of  Health, 
Civil  and  Sanitary  Engineer,  Winston,  N.  C. 


“  We  live  or  we  die — live  well  or  miserably — live  our  full  term,  or  perish 
prematurely,  according  as  we  shall  wisely  or  otherwise  determine.” 

Dr.  Henry  Maccormac  has  left  this  truism  as  a  monument  to  his 
superior  intelligence,  and  to  his  studied  appreciation  of  the  perfect 
development  of  Nature,  as  designed  in  Divine  creaiion  when  it  was 
given  to  mankind  to  enjoy  or  abuse — a  free  agency  of  the  effects  of 
creation  and  the  natural  laws  thereof. 

The  various  diseases  by  which  humanity  is  enfeebled,  both  bodily  and 
mentally — languishes  in  most  intense  suffering,  and  brought  to  prema¬ 
ture  death — are  not  our  natural  heritage,  but  the  perversion  of  a 
glorious  heritage  by  man’s  abuse  and  neglect  of  the  laws  and  demands 
of  nature. 

Baldwin  Latham,  the  eminent  English  sanitarian,  says:  “To  those 
who  have  carefully  studied  the  physiology  of  animal  life,  it  will  be  clear 
that  life  and  health  depend  upon  rightly  understanding  and  practicing 
those  laws  which  constitute  sanitary  science.”  Hippocrates  long  ago 
formulated  the  cardinal  principle  of  sanitary  science  and  hygiene  as  the 
maintenance  of  “pure  air,  pure  water,  and  pure  soil.”  It  is  for  the 
preservation  of  these  natural  elements  that  a  sewerage  system,  and 
other  sanitary  measures,  become  a  necessity  in  cities,  towns  and  villages 
where  life  and  health  are  fully  appreciated,  and  our  natural  heritage 
would  be  protected.  This  natural  heritage  may  be  described  in  the  lan¬ 
guage  of  Dr.  Stephen  Smith:  “Man  is  born  to  health  and  longevity; 
disease  is  abnormal,  and  death  (except  from  old  age)  is  accidental;  and 
both  are  preventable  by  human  agencies.” 

Diphtheria  makes  dark  and  desolate  the  former  joyous  and  happy 
home  by  taking  away  the  joy  and  boundless  pleasure-producing  jewels — 
the  innocent  children.  Typhoid  fever  takes  the  life  of  a  citizen  in  the 
prime  of  manhood,  with  all  his  wealth- producing  powers  fully  devel¬ 
oped.  An  epidemic  of  scarlet  fever,  yellow  fever,  typhoid,  diphtheria, 
dysentery,  or  some  other  of  the  preventable  diseases,  multiplies  desolate 
homes,  intense  suffering  and  premature  deaths,  and  we  raise  our  hands 
in  horror  and  wonder  how  a  kind  and  loving  Providence  can  inflict 
such  a  calamity  upon  our  religious  and  worshipful  community.  By 
thus  relieving  ourselves  in  sentimentality  we  may  restore  the  equilib¬ 
rium  of  a  guilty  conscience,  but  we  utter  the  rankest  blasphemy 
against  the  Divine  Creator  and  His  well-defined  laws.  We  are  the  cause 
of  the  epidemic;  we  are  the  guilty  ones.  It  is  the  criminal  disregard  of 


APPENDIX. 


LXVII 


the  laws  of  Nature  that  causes  this  preventive  sickness  and  premature 
death  of  our  fellow-man,  and  it  is  we,  ourselves,  who  must  carry  the 
moral  responsibility. 

Self-preservation  is  the  first  desire  of  all  life,  from  the  lowest  organism 
to  the  crowning  monument  of  creating  mankind.  There  is  a  universal 
longing  and  effort  to  this  end,  and  there  is  much  proof  to  demonstrate 
that  this  is  likewise  a  duty  imposed  by  the  Creator.  The  Mosaic  dis¬ 
pensation  clearly  illustrates  this  fact,  and  likewise  demonstrates  the 
universally  proven  and  accepted  maxim,  that  cleanliness  of  a  commu¬ 
nity  is  the  first  law  of  self-preservation — the  preservation  of  man’s 
natural  heritage  of  health  and  longevity. 

With  the  advanced  knowledge  of  the  law  of  cause  and  effect,  resulting 
from  the  sanitarian’s  scientific  study  and  investigation,  and  with  the 
results  of  sanitary  measures  before  us,  we  cannot,  as  intelligent  people, 
attribute  the  consequence  of  our  own  neglect  and  carelessness  to  a 
providential  cause.  We  must  recognize  that  a  large  proportion  of  the 
diseases  which  are  inflicted  upon  humanity  are  the  effects  of  prevent¬ 
able  causes,  and  that  it  is  possible,  through  the  medium  of  sanitary 
measures,  to  so  reduce  the  death-rate  as  to  materially  increase  the 
average  duration  of  life. 

The  alchemist  of  old  expended  his  time  in  search  of  a  hidden  sub¬ 
stance  of  nature  which  he  supposed  to  exist,  and  to  be,  in  fact,  an  elixir 
of  life,  supposing,  with  much  reason,  that  there  existed  some  subtle 
force  of  Nature  which,  if  utilized,  would  prove  to  be  a  panacea  for  all 
the  ills  to  which  he  reasoned  that  man  was  the  natural  heir.  Had  lie 
reversed  Ms  law  of  nature,  and  followed  the  true  natural  law,  he  would 
have  found  that  flesh  is  not  heir  to  disease,  but  that  disease  is  the  heir 
to  the  violations  of  nature’s  laws  in  the  flesh,  and  readily  found  his 
elixir  of  youth  in  these  same  sanitary  measures  which  the  studen  t  in 
sanitary  science  and  the  preservation  of  human  life  teaches  us  to  observe 
and  diligently  practice. 

The  romantic  Ponce  de  Leon,  when  he  left  the  crowded  metropolis  of 
Spain  and  sailed  across  the  ocean  to  an  unknown  and  uninhabited 
country,  in  search  of  the  fountain  of  perpetual  youth,  acted  with  some 
reason.  From  a  city,  where  pure  air,  pure  water  and  pure  soil  had 
been  destroyed  by  the  unnatural  accumulations  of  filth  and  uncltan- 
ness — a  very  hot-bed  of  disease  and  death  to  Gfod  s  own  fiee,  fail  and 
unpolluted  country,  where  naught  had  yet  come  to  destroy  the  life- 
giving  and  life-sustaining  elements  of  pure  air,  water,  and  soil,  was 
indeed  to  find  a  fountain  of  perpetual  youth,  for  who  can  gainsay  that 
fifteen  years  added  to  the  average  life  is  not  at  least  as  if  to  transform 

age  to  youth  ? 

This  same  fountain  of  youth  is  ours  but  for  the  taking  of  it.  V\  ould 
we  enjoy  it  in  congregated  communities  of  cities  and  towns,  to  v  hich 
we  are  wont  to  repair?  Then  but  remember  that  public  filth  is  public 


LX  VIII 


APPENDIX. 


disgrace,  and  that  sickness  and  death  is  the  natural  consequence  of  the 
abuse  of  nature’s  laws;  but  public  cleanliness  is  public  honor,  and  the 
practice  of  sanitary  measures  is  to  secure  intellectuality,  advanced  civil¬ 
ization  and  achievements,  health,  happiness  and  longevity.  To  main¬ 
tain  this  public  cleanliness,  provision  must  be  made  for  the  preservation 
of  the  natural  elements  of  pure  air,  pure  water  and  pure  soil,  by  at  once 
removing  the  effete  substances  of  the  body,  and  all  other  filth,  to  points 
remote  from  the  community,  by  the  construction  of  a  sanitary  system 
of  sewerage,  and  practicing  other  sanitary  measures  in  conjunction 
therewith.  Without  this  provision,  the  natural  soil  will  become  foul 
and  polluted,  and,  in  time,  totally  unfit  for  human  habitation. 

Would  you  not  leave  to  your  posterity  the  city,  town  or  village 
abounding  in  filth,  disease  and  premature  death,  with  all  their  train  of 
unhappiness,  pauperism,  crime,  enfeebled  mind  and  body,  and  a  degen¬ 
erated  civilization?  Then  have  a  care  how  you  carry  on  the  process  of 
soil-pollution;  for,  when  the  soil  becomes  impure  the  air  becomes  like¬ 
wise  impure  by  the  foul  emanations  from  the  soil.  The  water  is  also 
polluted  by  absorption  from  the  air  and  transfusion  from  the  soil;  and 
you  have  flagrantly  disregarded  the  cardinal  principle  of  sanitary 
science  and  nature’s  laws,  and  sickness,  epidemics  and  premature  death 
is  the  natural  result.  But  the  soil,  you  say,  is  a  purifier  of  filth.  It  is: 
but  this  property  of  the  soil  is  limited.  By  constant  absorption  of 
impurities,  the  soil  is  overloaded,  and  itself  becomes  impure,  and  it  is  no 
longer  a  purifier,  but  a  polluter,  in  the  effort  to  purify  itself.  Behold 
and  beware  of  the  sad  history  of  Rome,  once  the  proud  metropolis  and 
centre  of  civilization  of  the  world,  but  now  a  plague-stricken  city  for 
seveial  months  of  each  year. 

Ancient  Rome,  under  the  rule  of  the  Pagan  Kings,  had  her  Cloaca, 
Maxima  and  other  sewers,  which  ramified  the  entire  city.  Massive 
baths,  aqueducts  and  the  accompanying  sanitary  measures  maintained 
her  cleanliness,  and  the  observance  of  nature’s  laws  enabled  her  to  be 
a  grand  metropolis  of  health,  wealth  and  power.  But,  with  the  fall  of 
Rome,  we  find  the  necessity  of  sanitary  provisions  lost  sight  of  or 
unheeded,  and  the  more  modern  Rome  destroying  the  sewers,  tearing 
down  the  massive  baths  and  aqueducts  to  build  churches  and  monaste¬ 
ries,  totally  disregarding  the  accumulated  nastiness  of  the  years  during 
the  fall  and  recuperation.  Until  to-day,  Christian  Rome,  with  her  glori¬ 
ous  heritage  of  past  achievements,  having  permitted  these  sanitary 
works  to  pass  into  decay,  has  many  pages  of  her  more  modern  history 
blackened  by  the  most  horrifying  accounts  of  terrible  scourges  of  plague 
and  epidemics,  paying  the  natural  penalty  of  soil-pollution,  as  the  most 
deadly  and  dangerous  plague-spot  that  has  ever  blotted  creation. 

Under  the  present  regime ,  Rome  is  again  giving  due  attention  to  sani¬ 
tary  measures,  and  the  death  rate  is  being  gradually  reduced,  and  the 
deadly  Roman  fever  is  being  rapidly  obliterated. 


APPENDIX. 


LXIX 


If  we  investigate  any  age  or  any  people  of  which  history  records  the 
advancement  of  civilization,  art  and  science  to  any  degree  of  refinement 
and  excellence,  we  find  that  the  importance  of  sanitary  measures  were 
fully  appieciated  and  invariably  adopted.  Thus,  Alexandria,  Carth- 
age,  Hei culaneum,  Jerusalem,  Nineveh,  all  had  their  complete  systems 
of  sewerage  and  water  supply.  Under  the  Mosaic  dispensation,  all  sani¬ 
tary  laws  then  known  were  religiously  observed,  and  we  find  that  the 
Jews  had  a  clear  knowledge  of  the  necessity  of  removing  all  effete  sub¬ 
stances  and  filth  from  within  and  about  their  habitations.  The  duty 
and  necessity  of  observing  and  practicing  these  laws  of  nature  against 
soil-pollution  was  a  prominent  part  of  the  inspiration  to  Moses  when 
pursuing  the  divine  task  of  leading  the  Hebrew  tribes  out  of  the  wilder¬ 
ness  of  death  and  destruction.  The  devout  adherence  of  the  Jews  to  the 
practice  of  the  sanitary  laws  prescribed  by  Moses  has  given  to  that  race 
to  enjoy  greater  health  and  vigor,  even  to  the  present  day,  than  any 
other  race  of  people  on  the  face  of  the  earth,  in  similar  circumstances. 

As  we  advance  in  history  to  the  middle  or  dark  ages,  we  find  that  the 
importance  of  sanitary  measures  which  had  characterized  the  Jews  and 
the  Rome  of  the  Pagan  Kings  was  entirely  lost  sight  of,  and  the  statute 
books  bore  no  trace  of  these  important  laws — the  first  in  importance  for 
the  preservation  and  promotion  of  advanced  civilization  and  refinement. 
With  this  decline,  there  is  recorded  a  parallel  decline  in  art,  science  and 
civilization.  Beyond  question,  enlightenment  and  sanitation  are  insepa¬ 
rable  companions — the  advancement  of  the  one  requires  the  advance¬ 
ment  of  the  other. 

For  the  thousand  years  preceding  the  protest  of  Luther,  that  cardinal 
law  of  Christianity,  that  “cleanliness  is  next  to  godliness,*’  was  com¬ 
pletely  disregarded,  and  filth,  by  force  of  circumstances,  was  sanctioned 
by  the  influence  of  the  Christian  church.  The  Christian  outlaws  of 
Pagan  Rome,  to  maintain  their  faith,  were  forced  to  seek  refuge  from 
their  prosecutors  in  the  dark  and  filthy  catacombs  beneath  the  city,  and 
filth  and  unclean  personal  appearance  became  a  measure  of  the  sanctity 
and  personal  sacrifice  for  their  Christian  faith.  Through  this  cause  the 
importance  of  cleanly  surroundings  was  wholly  lost  sight  of.  But  the 
laws  of  nature  could  not  be  defied,  even  for  such  a  good  cause,  with 
impunity;  and  as  this  neglect  extended  from  person  to  community,  from 
community  to  city,  there  came,  in  due  time,  the  inevitable  result.  Out¬ 
raged  nature  aroused  them  from  their  insanitary  neglect  by  the  natural 
consequence  of  pestilence  in  various  forms  visited  upon  these  disregard- 
ants  of  nature’s  laws.  Epidemics  of  plague,  typhus  and  cholera  devas¬ 
tated  Europe  from  the  14th  to  the  17th  centuries,  much  more  terrible  in 
fatal  results  than  was  ever  caused  by  the  most  bitter  warfare  in  history. 
England,  in  twenty-two  (22)  years  of  continuous  warfare,  lost  79,700 
lives,  but  in  one  (1)  year  alone  cholera  robbed  her  of  144,860  lives. 


6 


LXX 


APPENDIX. 


During  the  prevalence  of  the  plague  at  York,  in  1664,  there  was  one 
(1)  death  to  every  three  (3)  persons  living,  but  during  the  cholera 
epidemic  of  1832  there  was  one  (1)  death  to  each  142  persons  living— an 
improvement  directly  traceable,  by  the  resurrected  city  archives,  to  the 
improved  sewerage  and  drainage  of  the  city.  In  the  year  following,  the 
city  of  London  is  supposed  to  have  lost  75,000  lives  by  her  last  visitation 
of  the  plague,  Black  Death,  as  it  has  been  called. 

The  history  of  the  town  of  Chester  furnishes  another  lesson  of  the 
fearful  results  attending  the  utter  neglect  of  sanitary  precautions  which 
characterized  the  degenerate  civilization  of  the  middle  ages.  Of  this 
we  have  the  following  record: 

“  In  1507  sweating  sickness  was  very  severe  in  Chester  for  three  days; 
ninety-one  died.  In  1517,  great  plague;  grass  a  foot  high  in  the  streets. 
1550,  sweating  sickness.  1603,  great  plague;  sixty  died  weekly;  in  all, 
650  persons.  1604,  plague:  812  deaths.  1605.  plague  still  increasing; 
1,303  deaths.  In  1649,  2,099  persons  died  of  the  plague.” 

Such  was  the  inevitable  result  of  the  disregard  of  nature’s  laws  for 
self-preservation,  “pure  air,  pure  water  and  pure  soil.”  These  unfor¬ 
tunate  people,  in  their  blind  ignorance,  charged  all  their  mysterious 
sickness  and  deaths  to  Divine  Providence,  as  some  are  inclined  to  do 
even  in  this  enlightened  era,  but  forgot  their  garbage-heaps,  foul  streets, 
dirty  houses,  personal  uncleanness  and  their  total  lack  of  sanitary  pro¬ 
visions.  Ignorance  cannot  be  plead  in  mitigation  of  violations  of  civil 
law,  much  less  in  physical  laws  of  nature.  Nature’s  laws  were  made 
unchangeable  for  all  time — irradicable  as  creation  itself.  “God  never 
breaks  His  laws;  He  never  permits  them  to  be  violated  with  impunity. 
They  operate  in  the  material  universe  with  inevitable  accuracy.” 

Gladly  do  I  turn  from  this  sad  history  of  the  past  to  the  more  cheerful 
task  of  recording  the  benefits  that  have  been  derived  from  the  prac¬ 
ticing  of  sanitary  measures,  but  this  pleasure  is  checked  by  the  thought 
that,  even  in  the  brilliant  enlightenment  of  our  present  century,  the 
lessons  of  the  past  have  been  but  poorly  learned.  We  have  had — and 
even  now  are  having — black  spots  in  our  own  country:  our  New  Orleans, 
our  Memphis,  our  Jacksonville  epidemics,  and  many  others  of  greater 
or  less  magnitude.  It  behooves  us,  as  a  country  and  as  a  State  of 
enlightened  people,  that  these  terrible  lessons  be  not  passed  over  lightly 
and  unheeded.  By  the  epidemics  of  New  Orleans,  in  1853,  there  were 
5,122  deaths  from  yellow  fever,  with  a  total  of  7,000  deaths  from  all  dis¬ 
eases.  In  one  day — August  22 — the  deaths  from  yellow  fever  numbered 
239.  This  great  number  of  deaths  were  recorded,  and  it  is  generally 
believed  that  there  were  many  deaths  also  which  were  not  recorded. 
Of  the  condition  of  the  city  at  the  time  of  the  outbreak  of  the  epidemic, 
we  are  told  that  the  streets  were  reeking  with  filth,  and  miasmic  odors 
prevailed  throughout  the  city,  caused  by  the  decomposing  animal  and 
vegetable  matter  that  had  been  scattered  promiscuously  throughout  the 


APPENDIX. 


LX  XI 


city.  Everything  had,  of  custom,  been  thrown  into  the  streets  that  the 
inhabitants  desired  to  be  rid  of,  and  lax  there,  seething  and  rotting. 
The  canals  and  their  tributaries,  and  the  city  drains  as  well,  were  covered 
with  a  green  slime  so  completely  that  the  water  was  entirely  hidden 
from  view.  In  the  pools  were  dead  animals  floating  about,  with  every 
other  description  of  animal  decomposition.  It  was  by  this  wretched 
insanitary  condition  that  the  seeds  of  epidemic  were  united  and  developed 
with  such  disastrous  results  in  the  loss  of  human  life.  Yellow  fever 
and  kindred  maladies  were  more  or  less  prevalent  in  the  city  till  1862, 
when  active  sanitary  measures  were  put  into  effect.  The  drains  were 
cleaned  out;  the  streets  were  scraped,  swept  and  washed  of  all  dele¬ 
terious  matter:  the  canals  and  their  tributaries  were  cleansed  of  their 
germ-festering  scum;  stringent  orders  were  issued  against  throwing  any 
filth  or  decaying  vegetable  or  animal  matter  in  the  streets  or  open  courts; 
all  refuse  matter  was  required  to  be  placed  in  proper  receptacles,  and 
was  then  promptly  removed  without  the  city  and  disinfected.  Every 
household  was  required  to  clean  up  its  premises  and  keep  them  clean. 
The  entire  city  was  placed  in  as  thorough  sanitary  condition  as  the  loca¬ 
tion  and  local  conditions  would  permit.  The  gratifying  result  of  this 
was  that  not  one  of  the  160,000  inhabitants,  or  the  many  thousands  of 
totally  unacclimated  troops,  was  stricken  with  yellow  fever  during  that 
year.  These  sanitary  measures  had  so  improved  the  general  healthful¬ 
ness  of  the  city  that  for  the  summer  of  1862  New  Orleans  is  said  to  have 
shown  a  less  rate  of  mortality  than  any  other  city  in  the  country.  These 
results  were  continuous,  and,  with  this  as  a  beginning,  the  city  entered 
upon  a  new  era  of  substantial  freedom  from  epidemic  and  malarious 
diseases.  They  exchanged  spoons  for  health.  How  can  we  appreciate 
the  enormous,  immeasurable  benefits  accruing  to  the  city  from  these 
sanitary  measures? 

The  financial  loss  by  the  yellow  fever  epidemic  of  1853  may  be  closely 
approximated  as  follows:  5,122  lives,  at  $1,000  each  (which  is  a  mini¬ 
mum  estimate),  amounts  to  $5,122,000;  estimating  five  cases  of  sickness 
to  each  death  (the  Jacksonville  epidemic  shows  ten  cases  to  each  death), 
the  cost  of  which,  including  loss  of  time,  medical  attendance  and  nurs¬ 
ing,  at  a  low  estimate,  would  be  $40  each,  or  $1,024,400,  making  a  total 
of  $6,146,400. 

The  city  of  Memphis,  Tennessee,  disregarding  the  valuable  lesson 
taught  by  this  short  page  of  the  history  of  New  Orleans,  scrupulously 
neglected  all  sanitary  measures.  The  streets  had  been  allowed  to  become 
filth  channels.  The  soil  of  the  city  was  permitted  to  become  not  unlike 
a  vast  compost  heap,  through  the  lack  of  a  sewerage  system  to  remove 
the  filth,  instead  of  carrying  on  the  continued  process  of  soil-pollution. 
The  laws  of  nature  had  been  totally  disregarded  and  violated,  with  the 
consequences  that  we  have  been  taught  by  the  history  of  centuries,  even 
from  the  time  of  Moses,  to  be  inevitable. 


LXXII 


APPENDIX. 


In  1878  we  see  Memphis  visited  by  a  terrible  epidemic  of  yellow  fever 
with  a  fatality  almost  unparalleled.  The  commerce  of  the  city  was 
entirely  suspended,  thousands  of  the  inhabitants  were  dead  and  dying, 
and  many  others  making  every  effort  to  desert  the  city.  The  city  gov¬ 
ernment  was  bankrupted  and  disbanded;  demoralization  and  panic  were 
general  throughout  the  city  until  cold  weather  came  and  put  a  check 
upon  the  ravages  of  the  dreaded  yellow  visitor.  In  the  meantime,  5,022 
persons  had  lost  their  lives  by  the  criminal  negligence  of  those  in 
authority  over  the  sanitary  and  general  condition  of  the  city. 

Only  after  this  costly  lesson  was  the  city  induced  to  seek  relief  by 
complying  with  the  lawful  demands  of  nature  through  the  practice  of 
sanitary  measures.  A  sanitary  system  of  sewerage  was  adopted  and 
executed  with  scientific  skill  and  efficiency.  Other  sanitary  reforms, 
made  possible  and  efficient  by  the  construction  of  sewers,  were  put  into 
practice,  with  the  gratifying  results  best  told  in  the  decreased  mortality 
and  absence  of  epidemics  since  these  measures  were  executed.  *  *  * 

Under  the  former  condition  of  the  city  the  annual  death-rate  per  1,000 
inhabitants  was  109,  while  under  the  present  regime ,  as  shown  by  the 
statistics  of  1887,  it  has  been  reduced  to  23.56  per  1,000.  With  the 
changed  sanitary  condition  seemed  to  come  a  new  confidence  and 
interest  in  life.  New  vigor  and  energy  characterized  the  inhabitants  of 
the  city,  and  its  healthfulness  attracted  immigration,  with  a  consequent 
great  increase  in  industrial  and  commercial  importance,  and  an  increased 
population  from  83,592  in  1880  to  65,000  in  1888. 

The  financial  value  of  this  increased  prosperity  can  hardly  be  esti_ 
mated,  at  least  the  proportion  due  to  the  changed  sanitary  condition. 
We  can,  however,  demonstrate  a  great  financial  saving  in  human  life 
and  healthfulness  alone,  directly  due  to  the  sanitary  measures  put  into 
practice. 

The  average  population  for  the  years  from  1880  to  1888  has  been,  in 
round  numbers,  45,000.  The  average  death-rate  reduction  may  safely 
be  placed  at  50  per  1,000  inhabitants,  or  a  total  saving  of  2,250  lives  annu¬ 
ally.  At  the  least  valuation  placed  upon  a  human  life  in  the  United 
States  this  saving  of  life  would  amount  to  $2,250,000  annually.  The 
number  of  cases  of  sickness  likewise  prevented  may  be  safely  estimated 
at  eight  to  each  death,  making  18,000,  the  cost  of  which,  including  loss 
of  time,  medical  attendance  and  nursing,  at  $50  each,  would  have  been 
$900,000.  These  two  items  make  a  total  annual  saving  of  $3,150,000. 

Estimating  six  per  cent,  upon  the  cost  of  the  sewerage  system,  and 
adding  the  annual  expense  of  carrying  on  the  work  of  the  very  excellent 
city  Board  of  Health,  makes  a  total  annual  expenditure  of  $36,337.86  to 
effect  this  enormous  annual  saving  of  human  life — in  money  value  only. 

The  epidemic  of  yellow  fever  at  Jacksonville,  Fla.,  and  other  Southern 
towns,  during  the  past  year,  is  but  further  results  of  the  lack  of  sanitary 
measures.  In  all  the  towns  where  this  epidemic  secured  any  foothold, 


APPENDIX. 


LXXIII 


it  can  safely  be  asserted  that  little  or  no  attention  had  been  previously 
given  to  their  sanitary  condition.  Th^se  communities  were  living 
amidst  the  accumulations  of  their  own  filth,  with  utter  disregard  to  the 
natural  law  against  air,  water  and  soil  pollution.  The  inevitable  result 
was  a  severe  epidemic,  with  all  its  train  of  moral,  physical  and  financial 
loss.  Hundreds  were  suffering  the  most  intense  agony,  and  premature 
deaths  were  numbered  by  the  score  before  sanitary  measures  were 
apparently  thought  of.  But,  when  such  an  epidemic  has  already  settled 
upon  a  community,  it  is  then  too  late  to  prevent  the  damages  by  any 
hygienic  means.  This  should  be  effected  before  the  outbreak  to  render 
a  full  return.  Though  it  is  happily  conspicuous  of  the  epidemic  at  Jack' 
sonville,  that,  owing  to  the  efforts  of  the  Sanitary  Committee  and  Board 
of  Health,  and  the  greater  knowledge  of  its  treatment  by  the  medical 
profession,  the  rate  of  fatality  has  been  reduced  to  one  (1)  death  to  ten 
(10)  cases  of  sickness,  and  the  extent  of  the  epidemic  has  been  compara¬ 
tively  very  limited — the  number  of  cases  having  been  4,700.  But  when 
the  seeds  of  such  epidemics  have  once  found  a  suitable  locality  for 
development  and  growth,  their  destructive  effect  is  beyond  the  control 
of  human  agency.  From  the  history  of  New  Orleans,  Memphis  and 
Jacksonville,  it  seems  to  be  clearly  deduced  that  a  yellow  fever  epidemic, 
like  every  other,  may  be  prevented  by  the  practice  of  sanitary  measures. 
But,  when  the  prevention  is  not  applied,  and  a  foothold  is  obtained,  cold 
weather  alone  can  check  its  ravages. 

Dr.  Morris  H.  Henry,  a  prominent  expert  on  the  origin  and  treatment 
of  yellow  fever,  recently  speaking  of  the  Florida  epidemic,  has  this  to 
say  regarding  the  intimate  relation  of  disease  and  death  with  insanita¬ 
tion  arid  unclean  surroundings:  “  The  popular  idea  of  yellow  fever  is, 
that  its  presence  is  accidental.  *  *  *  Yellow  fever  is  no  more  the 
result  of  accident  than  were  the  plagues  of  the  East  or  the  great  plague 
of  London.  The  plague  of  London  was  not  a  punishment  from  Divine 
Providence.  It  was  a  natural  sequence  of  the  absence  of  all  sanitary 
laws,  and  the  failure  to  adopt  any  prophvlatic  measures  to  prevent  the 
spread  of  what  are  now  known,  in  plain  Anglo-Saxon,  as  filth  diseases." 

BENEFICIAL  RESULTS  FROM  SANITATION. 

Illustrating  the  reduction  of  disease  and  mortality  of  towns  and  cities, 
due  directly  to  the  construction  of  efficient  systems  of  sewerage,  I  vt  ill 
first  quote  Sir  Douglass  Galton,  K.  C.  B..  F.  R.  S.,  an  eminent  English 
sanitarian,  in  an  address  before  the  Sanitary  Institute  of  Great  Britain. 
“  It  may  be  accepted  as  certain  that  in  every  case  where  the  seweiage  of 
towns  has  been  devised  in  sound  principles,  and  where  the  woiks  ha\e 
been  carried  on  under  intelligent  supervision,  a  largely  reduced  death- 
rate  has  invariably  followed.  The  records  of  Newcastle  afford  evidence 
of  this  fact.  The  quinquennial  period  ending  in  1881  showed  a  death- 


LX  XIV 


APPENDIX. 


rate  of  twenty-three  per  1,000,  whilst  the  death-rate  of  1881,  after  the 
completion  of  the  system  of  sewerage,  was  only  twenty-one  per  1,000.” 

“At  Munich  the  typhoid  fever  mortality  per  10,000  inhabitants  per 
quinquennial  period  was  as  follows: 


From  1860  to  1865,  when  there  was  no  sewerage  system . --16.8 

From  1866  to  1878,  when  there  was  partial  sewerage  system - 13.3 

From  1875  to  1880,  when  the  sewerage  system  was  complete - 8.7 


“  Similarly,  at  Frankfort-on-Main,  the  deaths  from  typhoid  fever  per 
10,000  inhabitants  were: 


From  1854  to  1859,  when  there  was  no  sewerage  system .  8.7 

From  1875  to  1887,  when  the  sewerage  system  was  complete . 2.4 


“At  Dantzic  the  figures  present  some  striking  characteristics;  the 
deaths  from  typhoid  fever  per  100,000  living  were  as  follows: 


From  1865  to  1869,  when  there  was  no  sewerage  or  water-supply - 108 

From  1871  to  1875,  after  the  introduction  of  water-supply .  90 

From  1876  to  1880,  after  the  completion  of  a  sewerage  system _  18 


“  At  Hamburg,  the  deaths  per  1,000  of  total  population  were: 

1838  to  1844,  before  the  commencement  of  the  construction  of  sew¬ 


erage  works . „ - - - 48.5 

1871  to  1880,  after  the  completion  of  the  sewerage  works _ _ 13.3 


“  During  the  time  that  the  works  were  in  progress,  viz.,  from  1872  to 
1874,  the  mortality  from  typhoid  was  as  follows: 


In  the  unsewered  districts . . . 40.0 

In  the  districts  for  the  most  part  sewered . . .  32.0 

In  the  fully-sewered  districts  . . . . .  26.8 


Dr.  Buchanan,  as  “Medical  Officer  of  the  Privy  Council”  of  England, 
in  the  ninth  report,  has  shown  the  marked  improvement  to  health  fol¬ 
lowing  the  introduction  of  systems  of  sewerage  and  water  supply  in 
twenty-five  cities  and  towns,  with  an  aggregate  population  of  593,736 
persons. 

This  report  shows  the  effects  of  providing  for  the  purity  of  the  air, 
water  and  soil  of  towns,  by  providing  water  from  an  uncontaminated 
source,  and  by  the  prompt  removal  of  all  effete  and  refuse  matter  before 
putrefaction  and  soil-pollution  could  take  place,  by  a  reduction  of  24 
per  cent,  in  the  mortality  of  typhoid  fever  alone.  Dr.  C.  W.  Chancellor, 


APPENDIX. 


LX  XV 


Secretary  of  the  Maryland  Board  of  Health,  and  a  thorough  sanitarian, 
states  in  his  "Report  on  Improved  Methods  of  Sewerage  Disposal  and 
Water  Supplies"  (from  which  these  quotations  are  taken),  that  it  is  fair 
to  presume  that  diphtheria  and  other  zymotic  miasmatic  fevers  would 
be  similarly  affected. 

Concerning  the  benefits  derived  in  England,  during  the  period  from 
1870  to  1880,  from  sanitary  measures,  the  Local  Government  Board,  in 
their  report,  speak  as  follows: 

“On  the  demonstration  of  various  model  instances,  it  may  be  held 
that  the  reduction  of  the  general  death-rate  by  per  cent.,  as  reported, 
satisfactory  as  this  is,  cannot  be  considered  more  than  one-tliircl  of  the 
results  obtainable  by  advanced  sanitary  administrations  and  further 
sanitary  works.  The  pain  and  misery  and  the  social  disorder  occasioned 
by  excessive  sickness  and  premature  mortality  are  greatly  beyond  pecu¬ 
niary  estimation.” 

Mr.  Baldwin  Latham,  the  eminent  English  engineer  and  sanitarian,  in 
his  work  on  “Sanitary  Engineering,”  gives  tabulated  results,  in  the 
annual  death-rate  reduction  per  1,000  inhabitants,  following  the  intro¬ 
duction  of  systems  of  sewerage  in  various  English  towns  and  cities, 
from  which  the  following  list  is  taken: 


Banbury — population  10,000:  death-rate  reduction  23.4  to  20.5 — 12|  per  ct. 


Cardiff —  “  38,000; 

Cray  den —  “  30.000; 

Ely—  “  8,000; 

Wacclesfield —  “  27,000: 

Newport —  “  25,000; 

Salisbury —  “  9,000; 


33. 2  to  22. 6 — 32  perct. 
23.7 to  18.6— 22  perct. 
23.9 to 20. 5 — 14  perct. 
29.8 to 28. 7 — 20  perct. 
31.8 to 2 1.6 — 32  perct. 
27.5 to 21. 9 — 20  perct. 


Unfortunately,  the  lack  of  statistical  records  of  American  towns  and 
cities  precludes  the  possibility  of  illustrating  as  fully  the  advantages  of 
sanitation  in  our  own  country ;  yet  the  fragmentary  data  that  has  been 
compiled  shows  equally  or  greater  gratifying  results  than  the  above 
showing  for  European  towns  and  cities.  The  statement  will  pass  unchal¬ 
lenged,  that  in  any  American  town  or  city  where  any  attention  whatever 
has  been  given  to  sanitary  measures,  greatly  reduced  sickness  and  mor¬ 
tality  among  the  inhabitants  has  been  the  result. 

The  city  of  St.  Louis,  Missouri,  furnishes  an  average  specimen  of  the 
benefits  to  be  derived  from  the  construction  of  sanitary  works.  In  I860, 
when  the  city  had  given  little  or  no  attention  to  sanitation,  the  annual 
death-rate  was  32  per  1,000.  This  extreme  rate  of  mortality  continued 
until  the  year  1865.  During  1865-’70  a  proper  sewerage  system  was 
constructed  and  accompanying  sanitary7  reforms  were  put  in  opeia- 
tion,  with  the  result  that  the  death-rate  in  18 <0  "was  20  per  1,000  inhab¬ 
itants — a  saving  of  twelve  human  lives  and  120  cases  of  pre\entable 


LX  XVI 


APPENDIX. 


sickness  in  each  thousand  of  the  city’s  population.  The  population  of 
St.  Louis,  in  1870,  310,864;  in  1860,  160,773.  The  average  population 
from  1865  to  1870  may  be  taken  at  298,341.  Thus  we  have,  as  the  result 
of  the  sanitary  works,  the  saving  of  298.34-j-12,  or  3,580  human  lives 
and  the  prevention  of  35,800  cases  of  sickness  annually.  The  financial 
value  to  the  city  of  these  results  is  shown  by  the  following  estimate, 
based  upon  minimum  values: 


3,580  human  lives  at  $1,000  — . . . . $  3,580,000 

35,800  cases  of  prevented  sickness  at  $50 . . .  1,790,000 

Total  annual  saving  of. . . . $  5,370,000 


In  the  foregoing  pages  I  have  endeavored  to  clearly  show  the  evil 
results  of  sanitary  neglect,  and  the  varied  and  positive  benefits  to  be 
derived  from  the  practice  of  sanitary  measures.  I  have  also  endeavored 
to  demonstrate  that  the  essence  of  all  sanitation  is  the  maintenance  of 
pure  air,  pure  water  and  pure  soil  in  and  about  the  habitations  of  man. 
Now,  the  question  will  naturally  arise:  How  can  these  elements  be  pre¬ 
served  in  their  primeval  purity,  and  what  are  the  constituent  features 
of  sanitation  as  regards  this  object?  Of  these  three  elements,  the  one 
directly  requiring  the  most  of  human  agency  is  the  soil. 

It  is  but  feebly  realized  what  an  important  part  the  soil  performs  in 
providing  health  and  happiness  to  our  lives.  Upon  this  very  largely,  if 
not  wholly,  depends  the  purity  of  the  air  and  water.  Polluted  soil 
means  polluted  water  and  impure  air.  If  we  preserve  the  purity  of  the 
soil,  the  air  and  water  will  retain  their  purity. 

The  soil  is  the  medium  by  which  nature  transforms  the  waste  product 
of  animal  life  into  vegetable  life.  Nature  has  provided  that  when  any 
of  her  agents,  whether  it  be  air.  water  or  food,  has  once  served  the  pur¬ 
pose  of  sustaining  animal  life,  that  it  becomes  totally  unfit  for  its  further 
promotion,  without  another  transformation — becomes,  in  fact,  destruc¬ 
tive  to  animal  existence;  but,  through  this  very  process,  these  agents 
have  lost  that  which  is  detrimental  to  vegetable  life  in  furnishing  the 
combustion  of  the  animal  kingdom.  They  are  then  prepared  for  the  sup¬ 
port  of  vegetable  life,  and,  by  vegetable  growth,  the  chemical  combina¬ 
tions  are  made  which  causes  this  inert  matter  to  become  again  prepared 
for  the  nourishment  of  man  and  animals.  The  vegetable  kingdom 
requires  for  its  support  that  which  forms  the  waste  product  of  the  animal 
kingdom.  It  utilizes  these  and  renders  a  product  again  suitable  for  the 
healthful  use  of  the  animal  kingdom.  Such  is  the  cycle  of  the  subtle 
forces  of  nature  in  a  grand  development.  While  the  atmosphere  plays 
quite  an  important  part  in  this  process,  the  first  few  feet  of  the  soil  is 
the  grand  laboratory  where  the  chemical  disintegrations  and  combina¬ 
tions  are  effected.  Consequently,  when  the  soil  is  polluted  by  accumu- 


APPENDIX. 


LX XV II 


lations  of  filth,  this  transformation  is  carried  on  in  order  that  the  soil 
may  again  purify  itself.  This  process  of  transformation  of  matter  has, 
either  as  an  agent  or  as  a  result,  the  development  of  low  forms  of  micro¬ 
scopic  life,  known  as  bacteria,  in  direct  proportion  to  the  amount  of 
filth  with  which  the  soil  is  charged.  These  minute  organisms  play  a 
large  part  in  the  processes  of  the  organic  world,  and  have  direct  relation 
to  many  of  the  common  diseases.  And  it  has  been  clearly  demon¬ 
strated  that  most  all,  if  not  every  one,  of  the  infectious  and  contagious 
diseases  are  directly  produced  by  and  dependent  upon  specific  forms  of 
these  micro-organisms;  that  these  minute  organisms,  developed  in  the 
decomposition  of  filth,  are  the  direct  cause  of  what  are  known  as  filth 
diseases,  viz.:  Typhoid,  yellow  and  scarlet  fevers,  diphtheria,  cholera, 
dysentery,  etc. 

The  soil  being  very  porous,  is  constantly  laden  with  large  quantities 
of  water  and  air,  and  when  these  bacteria  are  present  in  the  soil  the 
water  and  air  in  the  soil  become  likewise  their  carriers  and  direct  com¬ 
municators  to  the  human  body.  Ground-water  is  constantly  flowing 
through  the  soil  under  the  same  hydrostatic  laws  which  govern  the  flow 
in  streams,  always  seeking  a  lower  level,  and  the  streams  and  wells  are 
thus  supplied.  But  when  the  water  has  become  charged  with  bacteria, 
they  are  not  arrested  by  its  flowing  through  the  soil.  The  soil  will  arrest 
course  material,  such  as  grease  and  slime,  but  the  bacteria  diffuse  with 
ease,  and  follow  the  flow  wholly  unobstructed;  and  by  their  own  develop¬ 
ment  and  multiplicity,  and  their  accumulating  numbers,  they  derive  an 
accelerated  vigor  in  their  power  to  destroy  human  life. 

Hence,  a  privy-vault  or  cess-pool,  leeching  into  the  soil  and  developing 
bacteria,  charges  the  surrounding  soil  with  multitudes  of  disease-pro¬ 
ducing  micro-organisms,  which,  in  turn,  pollute  the  giound-water  and 
air-cells,  the  ground -water  flowing  on  to  supply  the  neighboring  stream 
or  well;  and  from  there  these  disease-germs  are  directly  introduced  into 
the  system  by  an  innocent-looking,  sparkling  beverage  which  nature 
intends  should  be  healthful  and  life-sustaining.  But  by  this  contamina¬ 
tion  it  is  transformed  into  a  rank  poison,  and  when  once  introduced  into 
the  system,  the  disease-germ  finding  suitable  conditions  for  development, 
intense  suffering  and  premature  death  is  the  result. 

Water  being  the  principal  agent  lor  conveying  nutrition  to  eveiy  pait 
of  the  human  system,  deleterious  matter  with  which  it  may  be  chaiged 
is  passed  very  rapidly  and  completely  to  the  whole  system  by  the  natuial 
absorption  of  the  blood. 

Directly  from  polluted  soil  we  likewise  have  polluted  air.  Decompos¬ 
ing  matter  is  invariably  exposed  on  the  surface  of  polluted  soil.  The 
gases  evolved  from  this,  as  well  as  directly  from  the  polluted  soil,  aie 
absorbed  into  the  atmosphere.  The  gases  from  animal  decomposition 
are,  like  those  from  the  soil,  charged  with  bacteria.  By  the  piocess  ol 
transfusion  of  gases  the  air  we  breathe  is  then  contaminated  ith  these 


LXXVIII 


APPENDIX. 


disease-germs.  The  air,  when  so  polluted,  makes  an  effort  to  oxidize 
and  purify  the  deterioiating  elements,  with  the  result  of  lost  vitality 
and  unfitness  to  sustain  animal  life  in  health. 

In  the  act  of  breathing,  these  noxious  elements  are  introduced  into  the 
system,  with  the  result  of  lowered  natural  vitality  and  great  suscepti¬ 
bility  of  disease,  and  the  blood  becomes  corrupted  just  as  effectually  as 
if  it  were  inoculated  by  any  known  poison. 

Pure  air,  pure  water,  and  wholesome  food  are  the  three  important 
agents  for  the  healthful  promotion  of  human  life;  they  are  likewise  the 
weapons  of  defence  against  the  ravages  of  disease  and  premature  death. 
These  natural  agents,  provided  in  their  normal  purity,  comfort,  health 
and  longevity  are  the  results;  if,  as  is  so  sadly  frequent,  they  are  provided 
in  an  abnormal,  polluted  state,  diseases,  epidemics  and  premature  deaths 
are  the  natural  sequence.  Popular  sanitation,  then,  resolves  itself  into: 
1st.  The  provision  of  wholesome  food  products,  and  the  disuse  of  such 
food  as  has  been  rendered  unwholesome  by  vicious  adulterations,  by 
improper  cooking,  by  decomposition  or  decay.  2d.  The  provision  for 
the  constant  exchange  of  breathed  or  vitiated  air  of  the  buildings  in 
which  we  reside  for  a  new  supply  from  the  atmosphere  without.  3d. 
The  maintenance  of  the  purity  of  the  soil  in  and  about  the  habitations 
of  mankind,  and  in  the  source  of  private  and  public  water-supplies;  and 
4th.  The  prompt  removal  of  the  effete  substances  which  nature  throws 
off  from  the  human  body,  and  all  other  filth  common  to  a  dwelling  or 
community,  to  some  point  without,  where  its  contaminating  influence 
cannot  be  exercised. 

The  sanitarian  and  scientist  will  continue  to  more  clearly  understand 
the  specific  nature  of  the  propagating  germs  of  different  diseases,  and, 
perhaps,  discover  the  agent  for  their  destruction.  They  will  further 
teach  many  valuable  lessons  for  the  protection  of  man’s  natural  heritage 
of  health  and  longevity.  But  the  four  factors  of  sanitation  given  above 
compose  a  wide  field  of  sanitation,  and  a  thorough  observance  and  prac¬ 
tice  of  their  teachings  will  lead  to  incalculable  results  for  good.  They 
are  of  such  vital  and  imperative  importance  that  they  should  constitute 
a  popular  study,  and  the  knowledge  of  their  effects  and  importance  be 
not  confined  to  but  a  few  persons.  All  should  study,  understand  and 
practice  them.  It  is  the  latter  two  of  these  factors  which  leads  directly 
to  my  subject.  It  is  the  necessity  for  the  prompt  removal  of  filth  and 
the  preservation  of  the  purity  of  the  soil  which  makes  a  sanitary  system 
of  sewerage  a  positive  necessity  for  towns  and  cities. 

I  have  already  shown  that  when  the  human  excreta  is  permitted  to 
accumulate  upon  the  soil,  or  to  leech  through  it  from  privy-vaults  or 
cess-pools,  in  any  community,  the  result  is,  impure  air,  water  and  soil. 
The  same  is  true  of  bath-room  slops,  kitchen  slops,  waste  water,  cast 
promiscuously  upon  the  surface  of  an  undrained  soil,  to  become  a  stag¬ 
nant  pool  or  hidden  moat,  and  all  the  other  various  forms  of  filth  com- 


APPENDIX. 


LXXIX 


mon  to  the  habitations  of  man  in  congregated  communities.  It  seems, 
then,  that  there  can  be  no  further  question  as  to  the  advisability  and 
necessity  of  getting  rid  of  these  substances  at  all  hazards.  The  question 
then  arises:  How  can  this  best  be  accomplished? 

Before  proceeding  to  a  discussion  of  the  various  expedients  for  the 
removal  of  filth,  I  desire  to  call  further  attention  to  the  condition  of 
things  where  no  such  provision  is  made,  but  where  the  deposition  of 
excretal  matters  is  made  in  cess-pools  and  midden  pits.  While  such  a 
practice  was  carried  on  by,  and  in  harmony  with,  a  primitive  condition 
of  society,  it  must  be  alluded  to,  as  we  need  not  go  back  to  any  remote 
period  to  find  the  people  addicted  to  such  a  loathsome  custom. 

Repulsive  as  it  is,  we  are  forced  to  admit  that  it  is  a  practice  of  our 
own  time  and  of  many  of  our  own  towns,  and,  in  many  cases,  with  lit¬ 
tle  or  no  useful  restrictions.  It  is  not  uncommon  to  find  large  sections 
of  many  of  our  towns,  with  the  only  place  of  easement  a  rough  struc¬ 
ture  enclosing  a  heap  upon  the  surface,  or  a  shallow,  open,  unwalled 
cess-pool,  within  thirty  or  fifty  feet  of  the  kitchen-door,  or  of  the  well 
which  is  supposed  to  furnish  wholesome  and  pure  water;  that  such  a 
supply  can  be  furnished  is  emphatically  an  anomaly.  It  seems,  therefore, 
urgently  proper  that  some  evidence  be  given  here  of  the  dangerous 
condition  engendered  by  such  insanitary  practices. 

It  has  already  been  demonstrated  that  excrementitious  matter  leech¬ 
ing  through  the  soil  is  fraught  with  great  danger  to  life  and  health; 
that  when  it  is  accumulated  upon,  or  within  the  soil,  it  is  thus  con¬ 
veyed  to  adjacent  wells,  is  just  as  certain  and  just  as  plain  as  that 
the  well  renews  its  supply  of  water  as  fast  as  it  is  drawn  out;  the  bacteria 
of  putrefying  human  excrement  passes,  with  water,  through  the  soil 
with  but  little  less  retardation  than  the  water  itself.  To  give  positive 
evidence  of  this,  I  will  quote  from  reports  and  analyses  given  by  Dr. 
W.  H.  Corfield,  “  Professor  of  Hygiene  and  Public  Health  at  Univer¬ 
sity  College,  London,  ex-President  of  the  Society  of  Medical  Officers  of 
Health,”  etc.: 

“Thus,  at  Harpenden,  Dr.  Hunter  reported,  in  1864,  that  the  wells 
were  near  to  the  cess-pools,  and  that  the  water  was  so  execrable  that  it 
was  actually  abandoned  by  the  people  themselves.  At  Bridgeport,  where 
the  cess-pools  were  often  mere  excavations  in  the  soil,  the  well-water 
became  turbid  after  rain,  and  it  has  been  known  to  smell  offensively, 
looking  yellow,  tasting  strongly,  with  a  pronounced  drainy  smell. 

In  the  reports  of  the  Medical  Officer  of  the  Privy  Council  (of  England) 
are  continually  found  such  statements  as  that  pumps  and  wells  aie 
“  foul  and  unfit  for  use  by  infiltration  from  cess-pools;  that  the  contents 
of  wells  are  very  foul,  it  being  sometimes  necessary  to  add  chloride  of 
lime  to  the  water  to  destroy  the  offensive  odor;  the  wells  and  cess-pools 
appeared  to  exchange  with  great  facility.’ 


LXXX 


APPENDIX. 


At  Rugby  it  has  been  physically  demonstrated  that  the  wells  were  fed 
by  the  cess-pools,  and  in  many  cases  “the  fluid  thrown  into  the  cess¬ 
pool  in  the  morning  is  pumped  from  the  well  at  night,”  and  yet  the 
taint  was  only  apparent  at  intervals,  or  when  the  water  had  been  kept. 
Thus  a  rank  poison  was — and  is — not  infrequently  innocently  self- 
administered.  Such  subtle  enemies  of  life  do  not  warn  us  of  their 
approach  with  a  blowing  of  trumpets  or  ostentatious  appearance,  but 
they  make  their  deadly  march  upon  us  in  an  obscurity  in  which  only 
the  trained  expert  can  detect  them,  rendering  popular  protection  from 
them  only  in  the  practice  of  preventive  methods. 

The  source  of  pollution  of  well-water  was  pointed  out  in  1844  by  the 
Health  of  Towns  Commission  (England): 

“As  houses  are  built,  and  neighborhoods  become  more  crowded,  the 
pollution  of  springs  (and  wells  should  be  added)  by  the  permeation  of 
matter  from  cess- pools  becomes  greater.”  And  though  the  cess-pools 
may  be  deepened,  and  even  cemented,  this  pollution  of  soil  and  water 
cannot  be  wholly  overcome. 

The  first  report  of  the  Rivers  Pollution  Commission  (English),  1868, 
contains  some  analyses  of  such  well-water.  In  the  case  of  a  very  deep 
well,  known  as  Bevington  Bush  Well,  at  Liverpool,  in  “  100,000  parts  of 
water  there  were  86.7  parts  of  solid  impurities,  containing  12.61  parts  of 
chlorine  and  8.721  parts  of  combined  nitrogen,  of  which  8.678  parts 
were  in  the  form  of  nitrates  and  nitrites,”  which  is  strong  evidence  of 
“previous  sew^age  contamination.”  The  amount  of  the  pollution  of 
this  water  is  clearly  given  in  the  following  statement  made  in  the  report: 

“Since  its  descent  to  the  earth  as  rain,  100,000  pounds  of  the  water 
had  been  contaminated  with  refuse  animal  matter  equivalent  to  that 
contained  in  86,510  pounds  of  average  London  sewage.” 

The  above  example  shows  that  even  the  great  depth  of  a  well  does 
not  prevent  its  being  contaminated  in  this  way;  though  it  does  tend  to 
show  that  there  is  a  greater  chance  for  the  oxidation  of  the  organic 
matters  in  percolating  to  a  depth  than  to  a  shallow  well.  The  report 
gives,  as  a  general  conclusion  about  deep-well  water,  that  “when  the 
well  is  at  a  distance  from  thickly-inhabited  places,  the  quality  of  the 
water  is  generally  excellent,  but  as  the  population  around  it  increases, 
the  water  gradually  becomes  mixed  with  a  lager  and  increasing  propor¬ 
tion  of  excremental  soakage.” 

Several  interesting  examples  of  the  pollution  of  well-water  by  excre- 
mentitious  matters  are  given  in  the  third  report  of  the  same  commission. 
Such  water  is  there  described  as  “the  bright  and  sparkling,  but  often 
dangerous,  beverage  drawn  from  shallow  wells,  sunk  into  ground  reek¬ 
ing  with  filth  and  excrementitious  matters.”  Thus  the  water  from  a 
well  at  the  Blue  House  School,  in  Frome,  “  contained  unoxidized  sewage 
matters,  besides  exhibiting  a  very  large  anterior  pollution  of  the  same 
kind.” 


APPENDIX. 


LXXXI 


k  Of  the  water  from  a  well  in  Durham  (England),  described  as  one  of 
the  best,  it  is  said  that  “this  water,  though  clear  and  sparkling,  is  shown 
by  our  analysis  to  be  little  else  but  the  percolations  from  sewers  and 
cess-pits;  100,000  pounds  of  it  contain  the  inorganic  remains  of  as  much 
excrementitious  matter  as  is  present  in  62,360  pounds  of  London  sewage, 
whilst  the  large  proportion  of  chlorine  which  it  contains  shows  that  a 
good  deal  of  urine  mixes  with  it.” 

Of  the  water  from  the  wells  in  Whitney,  varying  from  a  depth  of  six 
to  fifteen  feet,  it  is  said  that  “the  water  from  these  wells  is  frightfully 
polluted  and  entirely  unfit  for  human  consumption.  One  of  them  which 
we  have  analytically  examined  is  supplied  chiefly  from  percolations 
from  sewers  and^  cess-pools,  and  contains  a  large  portion  of  unoxidized 
sewage  matter,  besides  ammonia  from  urine.”  From  these  instances  it 
is  very  plain  that  well  and  spring  water  is  dangerously  polluted  by 
storing  excrementitious  and  other  filth  matters  upon  or  in  the  adjacent 
soil.  This  could  not  be  so  unless  the  soil  was  first  contaminated  by  these 
elements,  since  the  water  takes  its  foreign  and  impure  substances  from 
the  soil  as  it  percolates  through  it,  having  fallen  to  the  earth  in  rain  as 
a  pure  and  wholesome  beverage. 

That  impure  soil  makes  impure  air  there  is  no  more  question.  We, 
therefore,  have  clear  and  positive  proof  that  the  deposition  and  accumu¬ 
lation  of  excremental  and  other  domestic  filth  upon  or  within  the  soil 
about  our  dwellings  is  fraught  with  great  dangers,  and  it  is  a  positive 
and  infallible  cause  of  diseases,  epidemics  and  premature  deaths,  when 
produced  in  any  congregation  of  dwellings,  whether  it  be  village,  town 
or  city.  Such  matters  should  be  removed  to  points  outside  the  commu¬ 
nity  without  any  delay,  regardless  of  cost.  *  *  *  * 

The  various  methods  by  which  excremental  and  other  domestic  filth 
is  removed  from  within  communities  have  been  classified  under  three  (3) 
systems,  viz.:  1st.  Direct  removal;  2d.  Pneumatic;  3d.  WAter  carriage. 
The  first  is  generally  applied  to  excremental  matters  only;  the  second 
to  fmcal  matters,  and  a  minimum  quantity  of  water;  the  third  to  excre¬ 
mental  and  all  other  liquid  filth. 

Under  direct  removal  are  classed  all  the  dry  methods,  such  as  the  tub 
or  pail  systems— the  “Eureka,”  “Goux,”  “Rochdale,”  “Manchester,” 
etc.  Dry  closets— “  Moule’s,”  “ Phillips’,”  “ Taylor’s,”  “Sanford’s Carbon 

Closet,”  etc. 

Of  the  pneumatic  the  most  important  are  the  Lieurniei ,  Beiliei.  ’ 
“LeMarquand”  and  the  “  Shone  Pneumatic  Ejector.”  The  water-car¬ 
riage  systems  may  be  comprehensively  classified  as  the  combined  and 

separate. 

To  effect  a  sanitary  solution  of  the  problem  of  filth  removal,  any  sys¬ 
tem  must  comprehend  a  duty,  which  may  be  briefly  stated,  as  follows. 
The  immediate,  rapid  and  complete  removal  of  all  domestic  filth,  such 
as  waste  water,  water-closet,  bath-room,  bed-room,  laundry  and  kitchen 


LXXXII 


APPENDIX. 


slops,  to  some  point  or  points  without  the  town  or  city  where  it  cannoj 
exercise  a  contaminating  influence  upon  the  health  of  the  inhabitants. 

In  examining  the  various  systems,  I  desire  to  determine  to  what  extent 
they  accomplish  this  object,  and  from  which  may  be  derived  the  greatest 
sanitary  efficiency. 

The  Eureka  tub  plan  was  thoroughly  experimented  upon  at  Hyde, 
England.  It  consisted  of  the  ordinary  tub,  containing  a  small  quantity 
of  disinfecting  and  deodorizing  mixture,  placed  under  the  privy  seat  for 
the  reception  of  fa?cal  matters  only,  no  slops  being  permitted  to  be  added. 
The  sizes  of  the  tubs  were  adapted  for  several  days'  service.  When 
becoming  full,  they  were  exchanged  for  a  fresh  tub.  The  full  ones  were 
covered  by  a  tightly  fitting  lid  and  hauled  in  a  close  cart  to  a  manure 
manufactory,  where  the  contents  were  treated  with  more  disinfectants, 
and  ashes  were  added,  making  a  manure  of  little  value,  containing  only 
from  one  to  two  per  cent,  of  ammonia. 

The  working  of  the  plan  was  generally  considered  a  very  dangerous 
nuisance,  and  was  soon  abandoned.  The  plan  did  not  embrace  either  of 
the  three  essentials  of  a  sanitary  plan:  neither  an  immediate,  rapid  or 
complete  removal  of  domestic  filth. 

The  Goux  system,  otherwise  known  as  the  “Patent  Absorbent  Closet 
System,”  consisted  of  the  ordinary  tub  or  pail  system,  modified  by  lining 
the  tubs  with  some  sort  of  absorbent  material.  The  absorbent  material 
was  made  from  any  sort  of  refuse  animal  or  vegetable  fibrous  matters, 
mixed  with  a  small  percentage  of  sulphate  of  iron  or  lime  sulphate.  It 
is  pressed  closely  to  the  bottom  and  sides  of  the  tub  by  a  suitable  mold, 
leaving  a  cavity  in  the  center  of  the  absorbent  material;  These  tubs  are 
designed  as  receptacles  for  exci  emental  and  bed-room  slops  only,  and  are 
to  be  removed  weekly  or  twice  a  week.  In  practice,  this  plan  has  been 
found  to  be  of  but  little  use.  The  absorptive  capacity  is  very  soon 
exceeded,  and  the  tub  soon  becomes  the  simple  pail  method,  the  only 
accomplishment  being  the  prevention  of  soil  pollution,  with  no  regard 
for  the  purity  of  the  air  surrounding  the  tubs.  The  distinguishing  feature 
of  the  Rochdale  system  is  the  provision  of  a  receptacle  for  a  disinfecting 
fluid,  so  that  it  can  be  applied  to  each  deposition  of  fasces  and  urine. 
These  tubs  are  to  be  emptied  weekly  or  semi-weekly. 

In  the  Manchester  system  a  receptacle  for  ashes  is  provided,  so  that 
the  ashes  can  be  immediately  applied  to  the  dejecta,  acting  as  an  absorb¬ 
ent  and  as 'an  arrester  of  decomposition.  The  ashes  must  be  applied  by 
hand,  after  the  style  of  the  Hebrew  children,  with  the  paddle,  under  the 
Mosaic  dispensation. 

I  have  but  simply  described  these  modified  pail  systems,  as  I  think  a 
popular  acquaintance  with  their  details  to  be  of  little  value.  Wherever 
they  are  used  the  natural  tendency  will  be  to  harbor  the  filth  in  the 
community  for  a  long  time — at  least  until  the  receptacles  are  full  and 
running  over,  and  as  long  as  there  is  an  absence  of  unpleasant  odor.  It 


APPENDIX. 


LXXXIII 


is  so  well  determined  that  any  method  of  retaining  filth  within  the 
neighborhood  is  insanitary,  that  it  would  seem  a  dangerous  practice  to 
thus  encourage  this  retention. 

I  am  rather  of  the  opinion  that  the  common  pail  or  tub  closet  for  the 
deposition  of  excremental  matters  is  even  preferable,  as  their  infallible 
effect  upon  the  olfactory  nerves  serves  as  a  constant  reminder  of  their 
danger  and  of  the  necessity  for  frequent  removal.  It  may  be  freely 
asserted  that  any  pail  system,  without  embracing  daily  removal  and 
thorough  cleansing  and  disinfecting  of  the  receptacles,  is  an  extremely 
dangerous  and  unmitigated  nuisance.  ‘ 4  Moreover,  this  very  frequent 
collection  of  filth  by  hand  from  houses,  and  its  removal  almost  neces¬ 
sarily  under  the  eye  and  nose  of  the  household,  is  universally  condemned 
by  our  domestic  habits  as  nasty  and  offensive.’"  The  pail  system  can 
never  become  any  success,  either  from  an  economic  or  sanitary  stand¬ 
point.  It  fails  to  accomplish  either  of  the  three  requisites  of  a  sanitary 
solution  of  the  filth-removal  problem.  It  is  neither  immediate,  rapid 
nor  complete. 

DRY-CLOSET  SYSTEMS. 

While  the  dry- closet  systems  likewise  fail  as  a  sanitary  solution  of 
filth-removal,  they  are  entitled  to  somewhat  more  consideration,  since 
they,  in  a  great  measure,  overcome  the  dangers  of  the  pail  or  tub  sys¬ 
tems,  and  may  be  said  to  have  a  conditional  adaptability  of  some  value. 
That  they  do,  in  fact,  serve  as  a  very  valuable  method  for  villages  and 
very  small  towns,  I  shall  attempt  to  demonstrate. 

The  principle  upon  which  these  systems  are  operated,  is  that  ashes, 
charcoal,  and  some  sorts  of  dry,  pulverized  earth,  have  extensive  prop¬ 
erties  as  deodorants,  disinfectants  and  absorbents  of  excremental  mat¬ 
ters.  It  proposes  to  directly  apply  one  of  these  substances  immediately 
upon  the  excremental  matters.  As  stated  above,  however,  it  disregatds 
any  disposal  of  “slops”  and  other  household  wastes.  The  systematic 
application  of  these  properties  of  dry  earth  has  been  effected  by  some 
mechanical  applications,  introduced  by  Mr.  Moule,  and  designated  as 
the  Moule  system.  All  other  systems  are  but  modifications  of  the  essen¬ 
tial  features  contained  in  the  Moule  system,  hence  a  description  of 
this  will  quite  comprehensively  embrace  the  whole  dry-closet  system. 
Quoting  from  the  prospectus  of  the  Moule  s  Patent  Earth  Closet  Com¬ 
pany,  we  have  this  description  of  the  system:  "It  is  founded  on  the 
fact  of  the  deodorizing  power  of  earth,  a  given  quantity  of  dry  earth 
destroying  all  smell,  and  entirely  preventing  noxious  \apois  and  othei 
discomforts.  The  practical  application  of  this  povvei  consists  in  a  lesei- 
voir  for  containing  dry  earth,  and  an  apparatus  foi  measuiing  and 
delivering  the  requisite  quantity,  so  as  to  deal  with  every  opeiation  in 
detail.”  The  essential  features  of  this  system,  then,  would  seem  to  be, 


LX  XX IV 


APPENDIX. 


that  the  earth  should  be  dry,  and  that  each  faecal  deposition  should  be 
at  once  covered  with  a  sufficient  quantity  of  dry  earth.  The  application 
of  the  dry  earth  may  be  done  mechanically  or  by  the  hand;  the  mechanical 
arrangements,  however,  seem  never  to  have  applied  this  to  the  dejecta 
in  a  completely  satisfactory  manner.  It  would  seem  likewise  difficult 
to  apply  it  by  hand  so  that  the  entire  dejecta  would  be  covered  to  the 
requisite  depth  without  a  large  quantity  of  soil  is  used,  and  as  the  supply 
of  the  soil,  even  in  the  necessary  quantity,  is  the  expensive  part  of  the 
system,  this  becomes  a  formidable  objection.  The  earth  or  ashes  for 
this  purpose  is  stored  generally  in  a  reservoir  built  into  the  back  part 
of  the  closet,  and  the  requisite  quantity  is  applied  to  each  stool.  By  a 
chemical  action  of  the  dry  earth  the  complete  disintegration  of  the 
fa?cal  matters  takes  place,  and  no  excremental  matter  can  hardly  be 
detected  in  the  mixture,  except  by  a  slight  odor  that  arises  therefrom. 
An  accumulation  of  several  weeks  is  the  general  custom,  and  then  the 
mixture  is  removed  and  dried  and  used  again,  and  perhaps  again  as  dry 
earth.  While  the  substance  still  has  great  absorbent  properties,  it  can 
hardly  be  considered  a  safe  custom  to  repeat  the  use  of  the  same  soil 
without  having  first  given  it  an  opportunity  of  purifying  itself  by  pro¬ 
moting  vegetable  growth. 

The  dry-eartli  system  has  been  operated  in  many  military  camps, 
schools,  colleges,  hospitals  and  prisons  with  varied  success.  Wherever 
it  has  proved  a  failure,  or  caused  any  nuisance  or  disease,  it  may  be  safely 
asserted  that  it  was  due,  not  to  the  system,  but  to  the  improper  work¬ 
ings  of  the  system,  such  as  a  too  limited  supply  of  earth  or  improper 
mechanical  application.  The  great  drawback  to  its  use  has  been  the 
enormous  quantity  of  earth  to  be  supplied,  and  the  difficulty  in  obtain¬ 
ing  earth  suitable  f  or  this  purpose.  The  most  suitable  soil  is  rich  garden 
mold;  following  this,  in  order  of  merit,  is  peaty  soils,  black  cotton  soils, 
clays,  etc. ;  the  poorest  is  sand. 

The  quantity  of  soil  determined  by  practice  to  be  sufficient  to  remove 
all  smell  from  an  average  adult  stool,  varies  from  1-J  to  24  pounds, 
according  to  the  nature  of  the  soil  used,  and  2£  pounds  of  prepared 
proper  soil  is  necessary  for  each  use  of  the  urinal.  Provision  should  be 
made  for  three  (3)  uses  of  the  urinal  per  twenty- four  (24)  hours,  making 
a  total  per  adult  of  8f  pounds  daily.  It  would,  therefore,  require  for  a 
mixed  population  of  adults  and  children,  such  as  is  found  in  a  town  or 
village,  6f  pounds  per  person  per  day,  a  total  per  1,000  population  of 
6.375  pounds,  or  a  total  of  2.328,468  pounds,  or  1,164  tons  per  year,  and 
this,  together  with  the  ordure  to  be  removed,  would  amount  to  1,424 
tons,  making  the  total  transportation  per  annum,  per  1,000  persons,  2,588 
tons.  The  cost  of  this  system  may  be  estimated  as  follows:  To  dry, 
pulverize,  haul,  distribute,  collect  and  haul  away,  could  hardly  cost  less 
than  $2.00  per  ton,  or  $2,848;  the  resultant  product,  after  being  made 
into  a  poudrette,  might  be  sold  for  50  cents  per  ton,  reducing  the  cost  to 


APPENDIX. 


LXXXV 


$2,136  per  annum  per  1,000  persons.  Now,  applying  this  to  a  town  of 
10,000  inhabitants,  there  would  be  required  11,640  tons  of  earth  per 
annum,  and  a  cost  of  $21,360,  showing  clearly  the  impracticability  of 
operating  the  system  in  any  but  very  small  communities  or  detached 
public  institutions. 

In  very  small  and  sparsely  populated  communities,  where  each  house¬ 
hold  could  be  induced  to  prepare  its  own  dry  earth,  and  utilize  the 
resultant  upon  their  garden,  the  cost  would  be  reduced  to  a  minimum, 
and  give  a  service  which  would  be  a  large  improvement  upon  the  cess¬ 
pool  or  pail  methods. 

Besides  the  impracticability  of  this  system  for  larger  towns,  the  ser¬ 
vice  it  gives  is  but  trifling  as  compared  with  the  water  carriage  system. 
For  every  pound  of  human  excreta  treated  by  this  dry-earth  method,  it 
is  estimated  that  there  is  190  pounds  of  other  fluid  refuse,  of  which  it  is 
likewise  essential  that  it  be  removed,  and  which  is  removed  by  the 
water-carriage  system.  We  have,  then,  when  applied  to  large  commu¬ 
nities,  a  system  at  greatly  increased  cost,  but  giving  only  fi-1  part  of  the 
service  which  is  essential,  and  which  is  given  by  the  water  carriage 
system;  and  yet,  though  this  system  lacks  all  the  sanitary  requirements 
of  sewage  disposal,  it  is  likely  the  best  that  can  be  adopted  when  there 
cannot  be  obtained  sufficient  water  for  the  water-carriage  system. 

To  close  the  discussion  of  the  conservancy  systems,  I  will  quote  from 
an  authority  which  must,  indeed,  carry  conviction,  it  being  probably 
the  best  authority  that  can  be  found— -the  Committee  of  the  British  Asso¬ 
ciation  on  the  Treatment  and  Utilization  of  Sewage:  “  All  conservancy 
plans,  including  midden  heap  and  cess-pool  systems,  pail  closets,  dry-ash 
and  dry-earth  closets,  etc.,  are  quite  incompetent  as  the  solution  of  the 
general  questions  of  the  removal  of  the  refuse  matters  of  a  population. 
Such  plans  deal  only  with  a  small  part  of  the  liquid  measure;  towns 
which  resort  to  one  of  them  require,  therefore,  to  be  sewered.  Such 
plans,  moreover,  all  violate  one  of  the  most  important  of  sanitary  laws, 
which  is,  that  all  refuse  matters  which  are  liable  to  become  injurious  to 
health  should  be  removed  instantly  and  dealt  with  afterwards.  With 
all  these  plans,  it  is  an  obvious  advantage  on  the  score  of  economy  to 
keep  the  refuse  about  the  premises  as  long  as  possible;  and  the  use  of 
deodorants  of  various  sorts,  or  even  of  disinfectants,  proves  that  this  is 
the  case,  and  that  these  systems  all  depend  upon  a  fallacious  principle. 
They  should,  therefore,  be  discouraged  as  much  as  possible,  and  only 
resorted  to  as  temporary  expedients,  or  with  small  populations,  under 
exceptional  circumstances." 

PNEUMATIC  SYSTEMS. 

The  Pneumatic  systems  which  I  have  named  above  have  been  suc¬ 
cessfully  operated  in  several  cities  abroad  and  have  proved  themselves 


7 


LXXXVI 


APPENDIX. 


to  be  of  good  sanitary  service  and  especially  applicable  to  low-lying  dis¬ 
tricts,  and  such  places  where  sufficient  grade  for  the  water-carriage 
system  cannot  readily  be  obtained,  and  at  places  where  the  sewage  must 
be  pumped  to  be  conveyed  to  a  proper  outfall. 

The  distinguishing  feature  of  these  systems  is,  that  the  sewage  is  trans¬ 
ported  by  air  instead  of  by  water.  The  pipes  of  this  system  are  sealed, 
air-tight,  and  may  be  laid  regardless  of  grade  (except  in  the  Shone  sys¬ 
tem).  By  a  central  pumping  station  the  air  is  exhausted  from  them, 
causing  a  rapid  flowing  in  of  external  air  through  the  tilth  receptacles 
to  which  they  are  attached.  This  sudden  influx  of  air  carries  the  sew¬ 
age  before  it  at  a  great  velocity  until  it  is  all  collected  and  disposed  of. 
The  objections  that  may  validly  be  made  to  this  system  are  the  excessive 
cost  and  the  improbability  of  thorough  cleansing  of  the  pipes  by  the 
passage  of  air  through  them.  Inasmuch  as  we  have  nut  a  city  in  our 
State  which  would  probably  have  to  resort  to  this  method,  I  will  forego 
a  more  detailed  description  of  it,  and  pass  on  to  the 

WATER-CARRIAGE  SYSTEM. 

Water,  being  itself  the  great  scavenger  of  nature,  cleansing  our 
bodies,  our  clothes,  our  homes,  our  food  and  cooking  utensils,  it  is,  in 
fact,  the  natural  agent  of  all  cleanliness.  When  it  has  performed  this 
service  then  it  becomes  itself  foul  and  loaded  with  various  impurities, 
and  is  no  longer  in  a  condition  fit  for  the  uses  of  our  homes,  and  is  a 
great  source  of  danger  to  health  if  permitted  to  remain  about  our  habi¬ 
tations.  Consequently,  it  should  be  gotten  rid  of  at  once  in  the  most 
expeditious  manner.  In  getting  rid  of  this  waste  water,  it  is  made,  by 
the  aid  of  gravity,  the  carrier  of  excrement itious  matter  and  all  domestic 
filth.  We  have,  then,  a  method  effecting  the  immediate,  rapid  and 
complete  removal  of  domestic  filth  by  an  agency  which,  being  itself  an 
oxidizer,  checks  the  putrefaction  until  it  is  removed  beyond  a  point  of 
contaminating  influence.  This  agent  being  water,  this  method  is  very 
properly  known  as  the  water-carriage  system. 

By  the  proper  application  of  the  laws  governing  the  flow  of  water  in 
pipes,  and  by  the  proper  regard  for  known  features  concerning  the  flow 
of  sewrage  through  pipes,  this  system  is  made  to  solve,  in  the  greatest 
sanitary  degree,  the  problem  of  filth  removal.  In  proof  of  this  state¬ 
ment,  we  have  the  many  cases  of  death-rate  reduction — some  mentioned 
but  many  others  omitted  in  this  paper — due  to  sanitary  measures;  all 
have  been  effected  where  the  water-carriage  system  has  been  operated. 
Indeed ,  it  could  not  be  otherwise,  for  the  principle  is  obviously  the  correct 
one,  causing,  as  it  does,  the  immediate,  rapid  and  complete  removal  of 
all  deleterious  substances.  It  does  not  permit  filth  to  be  harbored  and 
experimented  with  upon  the  premises,  nor  to  remain  and  pollute  the  air, 
water  and  soil  immediately  surrounding  our  dwellings.  It  emphatically 


APPENDIX. 


LXXXVII 


should,  and  does,  first  remove  the  dangerous  excretal  and  other  effete 
substances,  to  a  point  beyond  the  power  of  exerting  deleterious  influ¬ 
ences,  and  permit  experimenting  and  utilization  schemes  to  be  practiced 
aftei  v  aids.  I  do  not  mean  to  say  that  the  manurial  properties  of  sew¬ 
age  should  not  be  utilized  and  returned  to  the  soil,  but  it  is  unques¬ 
tionably  the  proper  order  that  it  should  first  be  harmlessly  removed  and 
rendered  itself  harmless.  The  evil  should  certainly  first  be  overcome, 
even  should  it  cause  the  sacrifice  of  some  good. 

In  the  preceding  pages  I  have  shown  that  the  tendency  and  the  prac¬ 
tice  of  all  the  conservancy  or  dry  systems  is  to  retain  the  filth  about  the 
premises  for  a  long  time  after  having  simply  deodorized  it  by  dry  earth 
or  ashes;  that  it  is  thereby  rendered  harmless  is  only  a  presumption, 
and  its  correctness  has  not  been  borne  out  by  any  evidence  whatever. 
Since  we  know  so  little  of  the  effect  of  dry  earth  upon  the  disease-germs 
developed  by  putrefying  excretal  matters,  but  know  so  well  the  evil 
effect  of  these  germs  upon  the  health  and  life  of  man,  it  must  be  freely 
admitted  that  any  system  of  conservancy  is  based  upon  an  unsafe  and 
wrong  principle. 

The  only  safety  lies  in  getting  rid  of  these  obnoxious  agencies  in  the 
most  expeditious  manner,  and  this  is  admirably  done  by  the  water- 
carriage  system,  in  the  cheapest  manner  possible,  by  the  simple  aid  of 
gravity.  It  has  been  determined  in  practice  that  it  costs  but  one-tenth 
to  convey  by  water  and  gravity  of  the  cost  by  cart  removal. 

It  may  be  objected  that  a  water-carriage  system  of  sewerage,  con¬ 
necting  as  it  does  all  parts  of  the  town  or  city  by  a  vast  net- work  of 
underground  channels,  has  a  tendency  to  fVeely  circulate  evil  effects 
from  accumulations  in  the  sewer,  and  consequent  generation  of  delete¬ 
rious  gases.  But  this  is  not  a  valid  objection,  as  it  can  only  occur  from 
faulty  construction,  and  is  not  a  fault  of  the  system  itself.  In  construct¬ 
ing  a  system  of  sewers,  it  is  not  simply  necessary  to  dig  ditches  and  drop 
in  the  pipes,  fit  the  joints  with  a  little  cement,  and  pass  on.  Such  hap¬ 
hazard  work  in  anything  will  surely  prevent  successful  operation,  and 
the  evil  results  following  such  a  course  as  this  cannot  justly  be  attributed 
to  the  fault  of  the  principle.  It  is  the  abuse  of  the  good  principle  that 
produces  the  evil. 

In  practice  we  have  two  water-carriage  systems  of  sewerage,  the  “Sepa¬ 
rate  System”  and  the  “Combined  System/'  Under  the  “Separate 
System  ”  the  sewers  are  small  and  designed  to  carry  only  such  substances 
as  come  properly  under  the  head  of  sewage,  which  may  be  defined  as 
the  liquid  and  feculent  refuse  from  dwellings  and  their  appurtenances, 
leaving  the  storm-water  and  surface  drainage  to  be  treated  separately. 

Under  the  “  Combined  System,”  storm-water,  surface  and  subsoil 
drainage  is  ako  included.  Before  discussing  the  relative  merits  of  the 
two,  I  will  briefly  formulate  the  essential  features  for  fulfilling  the 
sanitary  functions  of  a  sewerage  system.  It  should  convey  all  sewage 


LXXXVIII 


APPENDIX. 


immediately  and  rapidly  to  the  outfall,  so  that  there  can  be  no  time  for 
decomposition  or  generation  of  gases  while  passing  through  the  sewer; 
to  effect  this,  it  should  be  of  proper  size  and  gradient,  of  smooth  bore, 
and  laid  to  true  alignment  and  gradient.  It  should  be  so  well  ventilated 
that  there  would  be  a  constant  interchange  of  air  from  within  and  with¬ 
out  the  sewer,  so  that  what  gas,  if  any,  might  be  generated,  would  be 
so  diluted  as  to  be  practically  harmless.  It  should  be  occasionally 
flushed,  so  that  no  accumulations  which  might  adhere  to  the  sewer  from 
irregular  flow  would  become  sufficiently  decomposed  to  generate  sewer 
gas.  It  should  be  impervious  to  water  and  sewage  throughout  its  length, 
to  preserve  the  soil  from  sewage  pollution.  To  recapitulate,  the  prime 
essentials  of  a  sanitary  sewerage  are: 

1st.  Immediate,  rapid  and  complete  removal  of  sewage  beyond  the 
point  of  danger. 

2d.  It  should  prevent  the  accumulation  of  noxious  gases  by  sufficient 
ventilation  and  proper  construction. 

3d.  It  should  be  susceptible  to  effectual  flushing. 

4th.  It  should  be  impervious. 

Any  sewer  deficient  in  either  of  these  requisites  is  a  foe  to  humanity, 
and  should  be  at  once  either  reconstructed  or  its  use  discontinued. 

For  the  “Combined  System”  the  sewers  are  necessarily  made  very 
large;  they  are  usually  constructed  of  brick  and  of  various  shapes.  The 
preferable  shape  is  ovoidal,  with  the  smaller  end  down,  as  this  form 
provides  maximum  velocity  to  the  minimum  flow.  The  brick  is  likely 
to  be  more  or  less  rough  and  porous,  causing  retardation  of  flow,  accu¬ 
mulations  of  shiny  substances,  and  organic  matters,  and  soil  pollution. 
In  time  of  severe  rain,  when  the  sewer  is  running  full,  or  nearly  full, 
the  excretal  matters,  being  in  suspension,  are  left  adhering  to  the  sides 
of  the  sewer  and  in  the  crevices  at  the  joints,  and  this  filth  must  remain 
there,  decomposing  and  giving  off  noxious  gases,  until  an  equally  severe 
storm  comes  again  to  wash  this  down  and  deposit  a  fresh  supply  of  this 
antidote  of  health  as  the  flow  recedes. 

With  each  heavy  rainfall,  there  are  various  substances  which  pass 
the  catch-basin  and  form  deposits  on  the  bottom  of  the  sewer,  causing 
accumulating  obstacles  to  the  flow.  By  these  obstructions,  the  sewage 
forms  itself  into  innumerable  cess-pools,  which,  in  the  dry-weather 
flow,  is  unmolested  in  its  natural  development  of  sewer  gas  and  bacteria, 
jeopardizing  the  health  and  life  of  every  inmate  in  each  house  with 
which  the  sewer  is  connected.  It  should  be  borne  in  mind  that  the 
native  heath  of  bacteria  is  in  just  such  dark  and  damp  places  as  this 
affords.  It  is  the  great  amount  of  sewer-gas  that  is  thus  generated 
which  makes  it  next  to  impossible  to  sufficiently  ventilate  such  sewers. 
They  can  be  ventilated,  and  much  external  air  introduced  into  the 
sewTer,  but  not  in  sufficient  quantity  to  overcome  or  purify  the  great 
volume  of  gas  that  accumulates  in  such  sewers.  A  very  great  and 


APPENDIX. 


LXXXIX 


extremely  popular  objection  to  the  combined  system  is,  the  great  cost 
of  providing  such  large  sewers  for  carrying  the  storm-water  to  a  distant 
point  on  account  of  its  contamination  when  mixed  with  excrementitious 
matters,  whereas,  if  it  were  not  so  polluted,  it  could,  in  most  cases,  at 
least,  be  readily  turned  into  the  natural  channels  and  safely  left  to  care 
for  itself. 

From  what  is  above  set  forth,  it  may  be  reasonably  claimed  that 
neither  of  the  essentials  named  above  can  be  secured  by  the  “  Combined 
System.” 

On  the  other  hand,  each  of  these  essential  features  can  be  secured  and 
all  these  objections  overcome  by  the  “Separate  System,”  when  designed 
and  constructed  with  proper  engineering  skill,  under  the  guidance  and 
direction  of,  and  with  due  appreciation  for,  the  sanitary  requirements 
and  the  laws  of  sanitary  science.  There  are  many  and  divers  objections 
to  the  “Combined  System,”  both  from  an  economic  and  a  sanitary 
standpoint,  which  I  might  discuss,  but  I  trust  that  enough  is  said  to 
convince  my  readers  that  it  is  a  radically  wrong  plan  to  turn  excretal 
filth  into  the  storm-water  sewers.  If  storm  sewers  must  be  built,  it 
will  add  but  comparatively  little  to  the  expense  to  construct  at  the  same 
time  a  system  of  impervious  pipe  sewers  from  the  domestic  filth  only. 

SEPARATE  SYSTEM. 

By  a  skillful  application  of  the  principles  of  the  “  Separate  System, 
the  solution  of  the  filth-removal  problem  is  greatly  simplified.  Instead 
of  planning  the  sewers  for  the  maximum  of  extremely  variable  flow,  as 
in  the  “Combined  System,”  with  an  enforced  disregard  for  the  dry- 
weather  or  sewage  flow,  we  deal  directly  with  this  flow,  with  a  com¬ 
parative  certainty  as  to  its  amount,  which,  as  compared  with  the  rain¬ 
water  flow,  is  quite  regular.  It  remains,  then,  but  to  determine  the 
quantity  of  sewage  which  the  system  will  be  required  to  convey,  and 
the  proper  adjustment  of  the  size,  form  and  kind  of  sewer  proportionate 
to  this  service,  to  secure  immediate,  rapid  and  complete  removal. 
Having  secured  this,  each  of  the  other  sanitary  requirements  aie  but 
matters  of  proper  design  and  construction.  That  the  sanitary  featuies 
and  health  preserving  efficiency  of  a  system  of  sewers  has  been  effected 
by  the  “  Separate  System  ”  to  a  degree  closely  approximating  perfection, 
has  been  in  many  cases  demonstrated,  both  in  this  country  and  in 
Europe,  where  the  system  has  been  put  into  operation  undei  a  studied 
appreciation  of  the  sanitary  requirements  and  skilled  direction. 

The  essential  feature  of  this  system  is,  that  the  sewers  shall  be  small, 
or  of  a  size  just  sufficient  for  the  service  which  it  is  designed  to  perfoim. 
It  has  been  determined  that  a  small  quantity  of  any  fluid,  "  hen  passing 
through  a  large  channel  or  conduit,  will  have  a  sluggish  flow  and  a  total 
incapacity  of  removing  obstacles  in  its  path;  but  this  same  quantity, 


xc 


APPENDIX. 


when  contracted  in  a  small  or  suitable  conduit,  flows  with  a  rapid  and 
accelerated  velocity,  with  effectual  scouring  properties,  removing  any 
ordinary  obstacles  that  may  be  in  its  path.  Hence  it  is  that  the  small 
sewers  of  the  “Separate  System”  give  a  service  vastly  superior  to  those 
of  the  “  Combined.” 

To  illustrate  this:  It  has  been  determined  that  a  six  (6)  inch  pipe  run¬ 
ning  half  full  of  sewage,  with  a  grade  of  1  in  40,  will  give  a  velocity  of 
3  feet  per  second,  while  the  same  quantity  of  sewage  passing  through  a 
twelve  (12)  inch  pipe  with  the  same  grade  will  have  a  velocity  of  but 
2  feet  per  second.  Again,  a  12-inch  sewer,  flowing  half  full,  with  a 
grade  of  1  in  200,  will  give  a  velocity  of  3|  feet  per  second,  a  thoroughly 
self- cleansing  velocity,  while  the  same  quantity  of  sewage,  flowing 
through  a  36-inch  sewer,  with  the  same  grade,  will  give  a  velocity  of 
If  feet  per  second,  which  is  not  a  self-cleansing  velocity. 

The  popular  demand  for  large  sewers  is  almost  wholly  founded  upon 
fallacy.  There  has  been,  to  some  extent,  a  strong  demand  on  the  part 
of  the  laity  and  board  of  town  commissioners  that  the  sewers  should 
be  made  “plenty  big  enough  and  some  to  spare,”  with  the  result  that 
the  sewer  falls  far  short  of  fulfilling  the  sanitary  demands,  and  the 
accumulations  therein  encouraged  and  effected  make  a  serious  item  of 
expense  in  their  removal.  The  popular  demand  regarding  sewers  should 
be  that  they  be  made  small  enough  to  perform  the  required  service  in  an 
economic  and  sanitary  manner.  In  a  small  sized,  properly  laid  sewer, 
and  properly  adjusted  to  the  required  service,  stoppages  will  rarely,  if 
ever,  occur,  while,  if  it  were  replaced  by  a  large  sewer,  stoppages  will  be 
constantly  occurring,  causing  a  large  cost  of  maintenance  and  seriously 
interfering  with  the  sanitary  service  which  it  is  sought  to  obtain. 

It  has  been  so  thoroughly  demonstrated  by  actual  experiment,  that 
there  can  be  no  further  question  as  to  the  efficiency  of  small  pipe  sewers. 
A  system  of  pipe  sewers,  properly  adjusted  and  not  too  large  for  the 
work  to  perform,  with  proper  grades  and  proper  construction  in  all  its 
parts,  will  immediately ,  rapidly  and  completely  remove  the  domestic 
filth  from  without  the  town  to  a  safe  outfall,  before  any  decomposition 
can  take  place,  and  while  the  sewage  is  comparatively  innocuous  and 
harmless.  Not  the  least  recommendation  of  the  “  Separate  System” 
is  the  wide  application  to  which  it  is  adapted.  Its  cost  being  but  one- 
fifth  or  one-sixth  of  the  “Combined  System,”  the  smaller  sized  cities, 
such  as  we  have  in  North  Carolina,  which  would  be  debarred  from  the 
advantages  of  sewerage  by  the  great  cost  of  the  “Combined  System,” 
can  have  all  the  benefits  of  the  removal  of  domestic  filth  before  the  soil 
has  become  saturated  and  polluted  by  its  habitual  accumulation,  by  the 
application  of  the  “Separate  System,”  and  at  a  comparatively  small 
expenditure. 

The  scope  of  this  paper  will  not  permit  going  into  the  details  of 
sewerage  plans  and  construction.  But  I  desire  to  briefly  notice  certain 


APPENDIX. 


XCI 


general  principles,  features  and  facts  connected  with  sanitary  design 
and  construction  of  a  sewerage  system,  which  should  be  well  known 
and  practiced,  especially  by  boards  of  city  commissioners,  when  the 
subject  of  sewerage  is  brought  up  for  discussion. 

PLANS. 

Whether  it  is  intended  co  construct  a  system  of  sewerage  for  the  entire 
town  or  city,  or  to  construct  sewers  only  for  the  most  thickly  populated 
districts  or  streets,  the  first  thing  to  be  done  is  to  have  a  complete  system 
designed,  embracing  the  entire  municipality  and  the  natural  drainage 
area  contiguous  thereto.  Having  the  design  for  the  system  as  a  whole, 
such  parts  as  are  desired  may  be  constructed  at  once  without  interfering 
with  the  future  construction.  This  section,  being  a  part  of  a  final  whole, 
is  perfectly  adjusted  to  the  future  demands  upon  and  the  future  exten¬ 
sions  from  it.  It  is  a  permanent  fixture,  and  unlike  sewers  which  are 
so  frequently  built  by  piecemeal,  and  without  any  order  as  to  harmo¬ 
nious  connections,  it  will  not  have  to  be  torn  up  and  reconstructed  when 
it  is  desired  to  sewer  the  remaining  portions  of  the  town  or  city.  But 
the  system  may  be  extended  as  required,  and  from  the  inception  to  the 
completion  the  system  will  be  adapted  to  all  its  parts,  and  continually 
serve  as  a  properly  adjusted  part  of  the  development  into  an  harmo¬ 
nious  whole,  each  part  being  properly  adapted  to  the  service  which  it  is 
intended  to  perform  in  securing  the  sanitary  benefits  of  a  properly  con¬ 
structed  system  of  sewerage. 

The  importance  of  this  point  cannot  be  overestimated,  for  it  must  be 
clearly  seen  that  in  a  comprehensive  system  all  the  parts  must  be  in 
intimate  relation  to  each  other,  and,  in  fact,  they  will  be  largely  inter¬ 
dependent  for  thorough  and  successful  service  of  the  system,  and  unless 
it  is  designed  as  a  whole,  this  regulation  of  the  parts  cannot  afterward 
be  obtained. 


MATERIAL  AND  FORM  OF  SEWERS. 


The  material  to  be  used  in  the  construction  of  sewers  should  be  vitrified 
salt-glazed  earthenware  pipe,  up  to  a  size  sufficient  to  discharge  5,000 
gallons  of  sew’age  per  minute,  viz. :  An  egg-shaped  sewer  with  diameters 
of  two  and  three  feet,  with  a  grade  of  one  inch  in  five  hundred. 

This  material  being  subjected  to  an  intense  heat  to  take  the  salt  glaze, 
is  very  hard,  durable  and  impervious.  The  glazing  protects  the  sewer 
from  the  disintegrating  action  of  the  acids  common  to  sewage,  and 
secures  a  smooth  surface  for  the  sewage  flow,  aiding  the  cleansing 
properties  of  the  sewer.  The  form  of  these  pipe-sewers  should  be 
circular  up  to  a  diameter  of  eighteen  (18)  inches,  and  with  some  qualities 
of  pipe  to  twenty-four  (24)  inches.  Circular  form  is  preferable,  as  it 


XCII 


APPENDIX. 


better  resists  the  resultant  of  the  external  and  internal  forces  acting 
upon  it,  and  because,  in  the  manufacture  of  sewer  pipe,  it  is  the  most 
economic  and  the  truest  in  form. 

The  elliptical  or  egg-shaped  sewers  have  much  in  their  favor  in  that 
they  secure  the  greatest  cross-section  of  flow  for  the  wetted  perimeter 
or  frictional  surface,  and  for  their  greater  ability  to  resist  the  vertical 
pressure  upon  them  which  is  the  greatest  of  the  external  forces.  So, 
that  for  sewers  laid  at  a  great  depth,  they  are  preferable  to  the  circular 
form.  In  the  iarger  sizes,  especially  where  the  volume  of  flow  is  likely 
to  be  subject  to  great  fluctuations,  they  are  likewise  preferable.  Their 
form  should  be  made  by  compounding  circular  arcs  of  three  different 
radii:  the  smallest  radius  for  the  bottom,  a  larger  one  for  the  top  and  a 
still  larger  radius  for  the  two  sides.  The  relative  lengths  of  the  vertical 
and  horizontal  diameters  varies  in  the  practice  of  different  authorities, 
but  a  safe  preference  is  the  vertical  equal  to  1£  times  the  horizontal 
diameter. 

SIZE  OF  SEWERS. 

The  size  of  the  sewers  in  any  system  is  dependent  upon  two  factors: 
the  volume  of  sewage  and  the  grades  obtainable.  The  chief  objects  to 
be  obtained  in  regulating  the  size  of  sewers  are,  that  they  shall  readily 
carry  the  maximum  volume  and  secure  a  self-cleansing  velocity.  The 
velocity  of  flow  is  dependent  upon  the  volume  and  rate  of  inclination. 
A  small-sized  sewer  must  have  a  greater  rate  of  inclination  than  a  larger 
one  to  secure  the  same  velocity,  but  the  larger  sewer  must  in  turn  have 
the  same  relative  volume  of  sewage  to  its  carrying  capacity.  Thus  a 
ten  (10)  inch  sewer  flowing  half  full,  to  give  a  velocity  of  4  feet  per  second, 
must  have  a  grade  of  1  in  180,  while  a  twelve  (12)  inch  sewer  will  give 
the  same  velocity  at  a  grade  of  1  in  160,  but  it  must  be  likewise  flowing 
one-lialf  full,  i.  e.,  the  volume  of  discharge  must  be  1,410  gallons  per 
minute,  almost  one  and  one-half  (1^)  times  the  volume  necessary  to 
secure  the  same  velocity  in  the  10-inch  sewer,  which  is  952  gallons  per 
minute.  Thus  we  see  the  need  of  the  conscientious  and  painstaking 
performance  of  duty  by  the  engineer  in  properly  adjusting  the  size  of  the 
sewers  of  a  system  to  the  obtainable  grades.  The  velocity  necessary  to 
secure  self-cleansing  properties  has  been  determined  by  experiment  and 
practice  to  be  not  less  than  three  feet  per  second  in  sewer-pipes  of  less 
than  twelve  inches  diameter,  and  not  less  than  two  and  one-half  feet 
per  second  in  pipes  of  twelve  inches  or  greater  diameter. 

The  minimum  rates  of  inclination  to  secure  this  velocity  is  given  by 
Latham  as  follows:  A  4-inch  house-drain,  1  in  90;  a  6-inch  sewer,  1  in 
140;  a  10-inch  sewer,  1  in  230;  a  12-inch  sewer,  1  in  450;  a  15-inch. sewer, 
1  in  550.  But  these  figures  presuppose  the  sewer  to  be  flowing 
one-lialf  (4)  full,  but  it  is  so  frequent  that  the  flow  will  be  somewhat  less 
than  this,  that  it  is  desirable,  when  working  to  minimum  grades,  to 


APPENDIX. 


XCIIJ 


figure  for  a  gi  eater  velocity  when  flowing  one-half  (i)  full,  in  order  to 
secure  a  self-cleansing  velocity  for  the  miniuium  flow.  This  velocity  is 
taken  at  4  feet  per  second  for  sewers  of  less  than  12  inches  diameter,  and 
at  34  feet  for  12  inches  and  greater  diameter,  in  determining  the  follow¬ 
ing  desirable  minimum  gradients: 

Diameter  4  inches,  gradient  1  in  53 


*  • 

6 

.  4 

4  4 

1  “ 

80 

4  4 

8 

*  * 

t  4 

1  “ 

105 

4  4 

10 

4  4 

4  4 

1  “ 

133 

*  4 

12 

4  4 

4  4 

1  “ 

238 

4  4 

15 

4  4 

4  4 

1  “ 

300 

4  4 

IS 

4  4 

4  4 

1  “ 

350 

I  have  already  referred  to  the  fallacious  popular  demand  for  large 
sewers,  so  I  deem  it  proper  to  show  the  actual  carrying  capacity  of 
various  size  pipe  sewers,  when  properly  constructed,  believing  that  the 
municipal  authorities  who  would  intelligently  act  upon  a  sewerage 
project  will  find  the  information  of  great  value  and  assistance.  In 
preparing  the  following  tabulated  statements,  I  will  assume  a  quantity 
of  60  gallons  of  sewage  per  capita  per  diem,  one- half  to  flow  off  in  eight 
(8)  hours — the  sewers  to  flow  one-half  full — which  is  a  liberal  assump¬ 
tion.  I  will  assume  also  the  above  minimum  gradients,  and  deduce  the 
following  data  of  the  actual  carrying  capacity  of  properly  constructed 
pipe  sewers : 


Diameter  of 
Sewer. 

Rate  of 
Inclination. 

Gallons  discharged 
per  hour. 

Equivalent 

Population. 

4  inches. 

1  in  53 

4,716 

1.258 

,6  “ 

1  “  80 

10,539 

2,812 

8  *• 

1  “  105 

19,003 

5,068 

10  “ 

1  “  133 

29.385 

7,836 

12  “ 

1  “  238 

34.402 

9,174 

15  “  ' 

1  “  300 

52.280 

13,941 

18 

1  “  350 

77.917 

20.778 

Thus  \\  e  see  that  a  four  (4)  inch  drain  is  amply  sufficient  for  dwellings 
and  good  siz.  d  hotels,  boarding-houses,  schools  and  public  institutions, 
and  an  eight  (8)  inch  pipe  is  proper  for  many  street  mains. 

Sewers  that  are  unnecessarily  large  are  not  only  a  useless  expenditure 
of  money ,  but  they  seriously  deteriorate  the  sanitary  service.  Ill-planned 
sewers  of  excessive  size  frequently  serve  to  carry  off  the  sewage  when 
the  poor  construction  would  cause  stoppages  in  sewers  of  the  proper 
size.  But  such  carry-off  of  the  sewage  is  not  the  service  that  is  contem- 


XCIV 


APPENDIX. 


plated  in  this  paper:  it  is  insanitary  and  extremely  dangerous.  It  cannot 
be  too  often  repeated  that  ill  planned  and  improperly  constructed  sewers 
are  dangerous  tilings  to  have  about,  and,  in  most  cases,  become  worse 
than  no  seivers  at  all.  “  Eternal  vigilance,”  both  in  design  and  construc¬ 
tion,  is  the  price  of  the  full  measure  of  sanitary  service  of  a  sewerage 
system. 

FLUSHING  AND  VENTILATION. 

These  are  classed  together,  as  the  object  to  be  attained  by  each  is  the 
same,  viz.,  to  prevent  the  generation  and  dangerous  accumulation  of 
sewer-gas.  There  would  be  but  little  or  no  danger  of  this  in  a  well- 
constructed  system,  removing  the  sewage  rapidly  to  the  outfall,  if  the 
sewers  were  always  canning  the  same  volume;  but,  as  the  flow  is  quite 
variable  for  different  days  and  for  different  hours  of  the  same  day,  there 
is  a  possibility  of  slight  generation  of  sewer-gas  by  the  small  particles 
and  slimy  matters  adhering  to  the  sides  of  the  pipes,  which  would 
probably  accumulate  to  dangerous  proportions  were  no  provision  made 
to  check  this  accumulation.  This  danger  is,  however,  very  effectually 
overcome  by  flushing  and  ventilation . 

By  flushing  is  obtained  a  periodic  washing  of  the  sewer  of  any  particles 
that  may  be  held  in  check  from  any  cause.  It  is  effected  best  by  flush- 
tanks,  which  discharge  automatically  at  regular  intervals  with  a  great 
velocity  and  consequent  cleansing  power. 

In  a  well  designed  and  constructed  system  the  periods  of  flushing  may 
safely  be  from  24  to  36  hours  apart,  but  in  other  case§  it  may  become 
necessary  to  flush  once  or  twice  each  day. 

The  quantity  of  the  flush  should  be  sufficient  to  secure  a  depth  of 
flow  slightly  greater  than  that  of  the  maximum  volume  of  sewage. 

A  flushing  apparatus  should  be  placed  at  the  head  of  each  main  and 
lateral  sewer,  and  in  some  cases,  at  intervals  along  long  lines  of  mains. 
Extensive  systems  of  sewers  should  be  divided  into  flashing  districts, 
the  districts  to  be  .flushed  consecutively,  beginning  at  the  head  of  the 
system. 

It  will  be  evident  that  by  such  systematic  and  thorough  cleansing  the 
generation  or  accumulation  of  any  great  volume  of  sewer  gas  is  pre¬ 
vented.  The  slight  quantity  which  is  in  practice  generally  found  to 
exist  in  sewers  is  innoccuously  disposed  of  by  proper  provision  for 
ventilation. 

This  consists  of  open  shafts,  connecting  the  sewer. with  the  external 
air,  causing  a  constant  interchange  and  circulation  between  the  atrnos. 
pheric  and  sewer  air.  The  sewer  air  is  thereby  diluted  to  a  harmless 
degree  and  left  free  to  maintain  a  uniform  tension,  whether  the  flow  of 
sewage  be  warm  or  cold,  great  or  small,  thereby  preventing  its  power 
to  force  the  trap  connections  of  houses  with  which  the  sewer  may  be 
connected. 


APPENDIX. 


XCV 


It  is  desirable  that  means  of  access  to  and  inspection  of  all  the  parts 
of  a  sewer  be  provided  by  the  construction  of  man-holes  and  lamp-holes 
at  short  intervals  along  its  course,  and  they  may  be  constructed  so  as  to 
serve  in  a  dual  capacity,  and  act  as  ventilating  shafts,  thereby  greatly 
assisting  to  obtain  the  desired  ventilation. 

DEPTH  TO  WHICH  SEWERS  SHOULD  BE  LAID. 

This  is  a  local  consideration,  dependent  upon  the  nature  of  the  soil 
and  other  characteristics  of  the  locality  to  be  sewered.  They  should, 
in  all  cases,  be  at  sufficient  depth  to  secure  the  proper  gradient  of  house 
drains  to  the  rear  of  the  dwellings  along  their  course,  so  that  for  sites  of 
great  irregularity  of  contour  they  should  be  laid  at  a  greater  depth  than 
for  localities  of  a  gently  rolling  or  level  surface. 

Since  no  branch  from  a  sewer  should  be  made  by  a  vertical  connec¬ 
tion,  it  will  be  seen  that  an  unnecessary  depth  of  the  sewers  is  a  useless 
additional  cost,  both  to  the  main  sewers  and  to  the  house  connections, 
so  that  the  minimum  allowable  depth  of  sewers  should  be  carefully 
determined  according  to  the  surrounding  conditions. 

Upon  this  subject  there  is  a  paragraph  contained  in  my  report  upon 
the  sewerage  of  the  city  of  Raleigh,  which,  I  think,  will  bear  repetition 
here,  as  follows: 

“In  determining  the  minimum  depth  to  which  the  sewers  shall  be 
laid,  I  have  departed  from  the  general  custom  of  laying  the  sewers  to 
such  depth  as  to  drain  cellars,  and  have  no  provision  for  cellar  service.  ' 
The  advantages  to  be  derived  from  cellar  service  in  sewer  pipes  is  the 
drainage  of  wet  or  flooded  cellars  in  wet  weather,  and  permitting  the 
placing  of  hopper-closets  in  damp,  dark,  out-of-the  way  places  in  cellars. 
While  these  may  be  advantages,  the  first,  at  least,  they  are  attended  by 
very  great  disadvantages  and  objections.  The  sewers,  in  many  cases, 
must  be  laid  to  nearly  twice  the  depth  to  provide  cellar  service — more 
than,  doubling  the  cost  of  construction.  The  limited  extent  to  which 
cellars  are  liable  to  be  flooded  in  this  city.  I  do  not  think  would  justify 
such  increased  expenditure.  The  great  objection,  however,  to  such 
service — and  I  deem  it  a  very  serious  one — is  the  provision  and  encour¬ 
agement  that  it  gives  for  placing  hopper-closets  in  cellars.  In  such  a 
climate  as  this,  such  a  practice  would, be  extremely  dangerous.  Closets, 
to  be  maintained  healthfully,  must  have  an  abundance  of  the  great 
purifying  elements — sunlight  and  fresh  air.  In  the  dark  corners  of 
cellars  they  can  have  neither  of  these,  and  in  the  warm  season  (consid¬ 
ering  human  carelessness)  I  see  but  little  to  prevent  them  from  becoming 
very  hot-beds  of  disease-germs — a  constant  menace,  not  only  to  those 
persons  immediately  around  them,  but  to  the  entire  city.  I  have,  there¬ 
fore,  designed  that  the  minimum  depth  of  the  sewers  should  be  just 
sufficient  to  be  below  all  water  and  gas  pipes,  beyond  a  possibility  of 


XCVI 


APPENDIX. 


contaminating  the  water  service.  Such  depth  I  consider  to  be  six  (6) 
feet  below  the  street  surface. 

“  We  might  permit  of  cellar  service  by  the  sewers  in  the  strictly  busi¬ 
ness  portion  of  the  city,  where  first  floor  and  cellar  space  is  very  valuable, 
in  such  cases  as  the  Sewerage  Committee  should  deem  urgently  desirable, 
but  with  the  greatest  restrictions  thrown  around  their  use,  and  the  care 
of  and  frequent  inspection  of  closet  connections.’’ 

In  a  city  or  town  where  cellars  are  liable  to  be  frequently  flooded,  pro¬ 
vision  should  be  made  for  overcoming  it,  as  it  is  very  detrimental  to  the 
health  of  the  community.  Rather  than  place  the  sewers  to  a  great  depth 
for  cellar  connections,  however,  it  will  be  found  more  economic  and 
of  much  greater  sanitary  service  to  lay  a  pervious  subsoil  drain  beneath 
the  sewers  at  sufficient  depth  to  lower  the  water  level  of  the  soil  below 
the  deepest  cellars.  In  localities  where  the  water  level  is  high,  the  soil 
retentive  and  wet,  and  where  phthisis  is  a  prevalent  disease,  a  system 
of  subsoil  drains  should  be  constructed  in  conjunction  with  the  sewerage 
system.  The  drains  may  be  either  beneath  or  beside  the  sewers  in  the 
same  trench,  thus  drying  the  subsoil,  which  has  been  found  in  every 
case  to  greatly  decrease  the  prevalence  of  this  sickness. 

In  the  foregoing  pages  I  have  consumed  as  much  space  as  the  occasion 
of  this  paper  will  permit,  and  perhaps  more  than  my  readers  may  enjoy, 
yet  much  that  should  be  said  is  but  only  imperfectly  and  incompletely 
alluded  to. 

I  have,  however,  endeavored  to  demonstrate  the  advantages  of  prac¬ 
ticing  sanitary  measures  and  the  clangers  arising  from  their  disregard. 
I  have  shown  that  the  essentials  are  the  provisions  for  the  maintenance 
of  "pure  air,  pure  water  and  pure  soil''’  in  and  about  our  homes.  It 
has  also  been  made  evident  that  the  first  provisions  looking  to  this  end 
are  a  pure  and  wholesome  supply  of  water  and  the  construction  of  a 
sanitary  system  of  sewerage.  Having  these  as  a  foundation,  a  complete 
and  perfect  system  of  sanitation  easily  becomes  a  reality;  without  fliese 
prime  essentials  no  amount  of  raking  and  scraping  and  garbage-collec¬ 
tion  can  be  developed  into  an  effectual  sanitary  service.  With  these 
provisions,  other  sanitary  measures  may  be  carried  out  to  perfection 
and  preventable  sickness  and  premature  death  may  be  wholly  eliminated 
from  the  list  of  the  results  of  moral  criminality. 

That  what  has  been  said  in  this  paper  may  conduce,  to  some  extent, 
to  the  consummation  of  this  greatly-to-be-desired  end,  has  been  the 
earnest  wish  of  the  writer  throughout  its  preparation. 

Winston,  N.  C.,  January  10,  1889. 


% 


APPENDIX. 


XCVII 


HOW  CAN  WE  BEST  SECURE  ECONOMICAL  DISPOSAL  OF 
REFUSE  IN  OUR  TOWNS?  SOME  REMARKS  ON  THE 
GARBAGE  FURNACES  IN  USE. 


By  Thomas  F.  Wood,  M.  D.,  Secretary  North  Carolina  Board  of  Health, 

Wilmington. 


The  refuse  of  towns  consists  of  two  distinct  classes,  most  conveniently 
considered  under  the  general  terms  Wet  and  Dry. 

The  wet  includes  kitchen  refuse,  and  night-soil,  dead  animals,  etc. 
The  dry  includes  street  sweepings,  ashes,  cast-off  clothing,  shoes,  sweep¬ 
ings  of  workshops,  etc.  The  division  of  garbage  as  above  is  not  in 
reality  one  which  is  observed,  but  w^hich,  if  observed,  would  make  pos¬ 
sible  a  more  ready  way  of  collection  and  disposal. 

What  to  do  with  garbage  is  a  question  which  has  been  answered  in 

the  past  in  some  of  the  following  ways:  The  dry  garbage  usually  dumped 

in  some  of  the  suburban  localities,  generally  to  fill  up  wet  or  low  places, 

making  a  foundation  for  future  building  lots.  When  the  once  harmless 

dry  garbage  became  decomposable  by  moisture  and  commenced  to  send 

out  its  malodorous  effluvia,  particularly  if  it  happened  to  be  a  season  of 

unusual  sickness,  there  would  be  a  grand  display  of  dosing  it  with  carbolic 

acid  and  lime,  or  else  giving  it  a  covering  of  nice  clean  sand.  There  is 

hardly  a  town  on  the  Atlantic  coast  that  has  not  committed  just  this 

folly.  More  than  this,  there  is  hardly  one  of  these  towns  which  has  not 

made  it  a  rule  to  thus  dispose  of  dry  refuse;  or,  at  any  rate,  permitted 

scavengers  to  go  on  in  an  old  rule  handed  down  to  us  from  the  remote 

times.  Then,  as  our  towns  have  spread  out,  and  these  dumping-grounds 

became  valuable  for  lots,  it  possibly  had  passed  out  of  the  memory  of 

the  ones  most  interested — the  intending  purchaser — that  the  foundation 

his  new  house  was  about  to  be  built  on  was  composed  of  old  shoes,  cab- 
** 

bage-stalks,  rags,  bones  of  desiccated  carcases  of  domestic  animals,  and 
his  well  must  penetrate  a  subsoil  of  decomposed  organic  matter,  which, 
if  purposely  intended  to  poison  his  drinking-water,  could  hardly  have 
been  better  prepared. 

All  would  look  exceedingly  fair  with  a  handsome  little  cottage,  painted 
and  adorned,  even  on  a  dumping-ground  foundation;  and  when  sick¬ 
ness  came,  the  theories  of  malaria  would  account  for  it  sufficiently  to 
lead  the  owner  to  look  to  a  river  or  creek  a  mile  off,  possibly,  and  not  to 
his  foundation.  In  fact,  he  might  disclose  the  wonderful  fact  that  his 
well  yielded  genuine  sulphur  water — from  the  products  of  decomposi¬ 
tion  of  his  subsoil  basis.  The  writer  recalls  two  cases  of  this  sort.  In 
the  suburbs  of  one  of  our  larger  towns  a  good  spring  of  clear  water  was 
discovered,  possessing  the  remarkable  odor  of  sulphur  (or  sulphureted 


XCVIII 


APPENDIX. 


hydrogen),  and  so  at  once  raised  to  the  rank  of  a  medicinal  spring. 
Ladies  and  children  trooped  to  the  place  to  imbibe  the  health-giving 
fluid,  with  entire  confidence.  But  the  fatal  day  came;  the  ditcher’s 
spade  invaded  the  region,  going  down  through  the  ancient  layer  of  decom¬ 
posing  garbage,  and  the  sulphur  disappeared  from  the  wa,ter,  and  its 
repution  departed! 

The  other  case  was  one  reported  of  a  New  England  watering  place. 
It  became  quite  noted  for  the  strength  of  its  sulphur  water,  and  it 
became  necessary  to  pull  down  and  add  to  the  hotel.  In  doing  this,  the 
ancient  privy  vault  was  destroyed  or  removed,  and  the  sulphur  disap¬ 
peared  from  the  water,  and  the  glory  of  the  resort  departed. 

We  need  not  dwell  upon  the  harmfulness  of  garbage,  as  anything  so 
capable  of  being  a  nuisance  to  our  sense  of  cleanliness,  and  so  certain  an 
index  of  laziness  and  neglect,  ought  to  be  systematically  fought  against. 
Five  years  ago  the  North  Carolina  Board  of  Health  issued  a  pamphlet 
entitled  “  A  Year's  Campaign  Against  Dirt,"  being  suggestions  to  citi¬ 
zens  of  cities,  towns,  villages  and  hamlets  how  to  keep  their  streets  and 
homes  in  a  healthful  condition.  It  had  a  large  circulation,  and  stimu¬ 
lated  some  towns  to  a  serious  consideration  of  the  ways  and  means,  but 
what  was  the  practical  application  of  the  lesson  is  not  yet  apparent  in 
our  towns. 

Long  years  of  observation  have  brought  the  writer  to  the  conclusion 
that  the  failure  to  keep  our  streets  rid  of  the  garbage  is  due  to  the  failure 
to  destroy  it.  The  ceaseless  round  of  hauling  it  to  waste  places,  seeking 
new  places  when  necessary,  then  going  back  to  the  old  dumping-ground 
when  decay  has  reduced  the  piles  of  dirt  to  admit  of  it,  engenders  habits 
of  indifference,  besides  being  fruitful  source  of  complaints  of  neighbors 
and  passers-by. 

Another  cause  of  imperfect  service  by  scavengers  is  the  waste  of  time 
in  hauling  to  the  dumping-ground.  Of  necessity  such  accumulations 
must  be  distant  from  habitations,  and  a  long  haul  means  expense;  and 
this  latter  obstacle  is  so  great  that  subterfuges  are  often  resorted  to, 
especially  the  subterfuge  of  neglect. 

Plans,  therefore,  to  be  effectual  must  be  expeditious;  must  be  inex¬ 
pensive;  must  hold  out  encouragement  to  the  authorities  having  super¬ 
vision  of  it  that  some  real  good  is  being  done. 

Let  us  take  up  two  of  the  plans  which  have  had  somewhat  recent 
trials.  The  city  of  New  Oi  leans  adopted  the  plan  of  removing  the  gar¬ 
bage  by  the  river;  having  a  long  river-front,  with  a  short  haul  across 
the  city  to  wharves,  loading  on  dumping-scows  and  discharging  at 
some  convenient  place  beyond  the  possibility  of  barm.  A  similar  plan 
was  suggested  in  Wilmington,  but  was  never  carried  out,  although  there 
the  facilities  are  very  good.  The  river-front  is  two  miles  long,  the  tide 
ebbs  and  flows  twice  daily,  making  it  possible  to  establish  upper,  lower 
and  middle  wharves  at  which  to  load  the  scows,  with  mud- flats  above 


APPENDIX. 


XCIX 


and  below  the  city  upon  which  the  garbage  could  be  deposited,  accord¬ 
ing  as  the  tide  was  running,  up  or  down;  making,  in  all,  an  economical 
arrangement. 

Doubtless  there  would  be  some  objections  to  a  plan,  however  good, 
when  we  come  to  the  practical  working  details;  but  if  not  left  to  the 
stupid  management  of  such  labor  as  is  usually  selected  in  our  towns,  but 
supervised  with  due  intelligence  by  officers  of  energy,  could  be  made  to 
accomplish  good  results. 

At  the  present  time  there  is  more  hope  for  the  establishment  of  thorough 
policing  of  our  streets,  alleys  and  back  yards  by  the  introduction  of  gar¬ 
bage  furnaces. 

When  it  is  demonstrated  that  the  filthy  accumulations  of  our  towns 
are  being  destroyed  beyond  the  possibility  of  further  harmfulness,  and 
without  nuisance  in  the  process  of  destruction,  citizens  will  take  courage 
and  imbibe  new  ideas  of  energetic  removal,  the  garbage  carts  will  make 
prompter  visits  to  the  furnaces,  and  our  towns  will  have  the  appearance 
of  cleanliness  unknown  now. 

At  the  Milwaukee  meeting  of  the  American  Public  Health  Association 
last  November,  Dr.  Kilvington,  of  Des  Moines,  gave  us  a  historical  and 
practical  description  of  the. garbage  furnace,  from  its  first  inception  to 
the  outcome  in  the  Engle  furnace.  With  my  colleague,  Dr.  Bahnson,  I 
witnessed  the  working  of  the  Chicago  crematory,  through  the  kindness 
of  Dr.  Oscar  DeWolfe,  health  officer  of  that  city.  The  furnaces  did 
their  work,  consuming  immense  quantities  of  garbage  of  every  sort, 
excluding  night-soil.  These  furnaces  had  the  defect  of  not  consuming 
the  smoke  and  gases  of  combustion,  and,  although  the  chimney  was 
very  high,  the  odors  were  quite  perceptible,  and  would  not  fail,  at  some 
times,  to  be  a  nuisance  in  thickly  settled  parts  of  the  city.  The  difficulty 
of  consuming  the  smoke  and  offensive  gases  is  accomplished  in  the  Engle 
furnace,  one  of  which  was  established  recently  and  started  operations  as 
a  demonstration  of  the  capacity  of  this  model,  for  the  benefit  of  the 
visitors  to  the  American  Public  Health  Association,  and  there  is  one  also 
at  Des  Moines.  This  furnace  accomplishes  its  work  most  thoroughly, 
and  in  the  smaller  towns  would  do  even  better. 

The  following  description  of  the  Engle  furnace  is  from  a  paper  by  Dr. 
S.  S.  Kilvington,  in  the  Sanitarian  for  December,  1888: 

“In  conclusion,  let  me  invite  your  attention  briefly  to  the  only 
remaining  patent  left  for  our  discussion — the  Engle  crematory,  an 
invention  which  has  demonstrated  or  is  demonstrating  its  own  success 
in  the  cities  of  Minneapolis,  Des  Moines  and  Milwaukee.  As  constructed 
in  the  city  of  Minneapolis  and  duplicated  here  in  the  city  of  Milwaukee, 
we  have  an  elongated  each  furnace.  Its  cremating  chamber  is  38  feet 
long  by  5  feet  wide.  It  has  a  height  of  arch  from  the  grate  to  the  dome 
of  7  feet  clear. 

“As  shown  in  the  accompanying  cut,  representing  a  vertical  longi¬ 
tudinal  section  of  the  structure,  at  the  end  of  the  grate  nearest  to  the 


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APPENDIX. 


Cl 


chimney  flues,  but  not  in  connection  therewith,  is  the  primary  fireplace. 
Beneath  the  grate,  throughout  the  whole  length,  is  an  elongated  ash-pit, 
which  is  floored  with  fire-clay  tiles,  and  which  forms  the  roof  of  a  super¬ 
heated  smoke  flue,  which  I  shall  presently  describe.  At  the  end  of  the 
furnace  most  remote  from  the  chimney  shaft  is  a  fire-grate,  four  feet 
below  the  level  of  the  first,  upon  which  a  secondary  fire  burns.  Between 
this  and  the  chimney  shaft  runs  the  long  horizontal  smoke  flue  to  which 
I  have  already  referred,  with  its  superheated  tiled  roof,  continuing  for  a 
length  of  28  feet  to  the  chimney  shaft,  which  rises  100  feet  in  height. 
The  building  in  which  the  furnace  is  enclosed  is  of  three  stories.  At  the 
level  of  the  first  floor  is  a  double  row  of  doors,  the  upper  of  which  gives 
opportunity  for  feeding  the  primary  fire  and  for  stoking  the  burning 
material,  while  the  lower  row  opens  into  the  ash-pit  and  permits  the 
removal  of  ashes.  At  the  farther  end  of  the  furnace,  upon  this  same 
floor,  are  doors  for  supplying  the  secondary  fire  and  removing  any  ashes 
it  may  produce.  The  second  floor  is  at  the  level  of  the  top  of  the  brick 
furnace,  and  upon  this  floor  are  delivered  the  bodies  of  dead  animals, 
which,  by  means  of  pulley  attachments,  are  lowered  through  a  large 
tubular  shaft,  rising  to  the  level  of  this  story  and  discharging  into  the 
furnace  at  a  point  near  the  primary  fire.  To  the  level  of  the  third  story 
rise  from  the  furnace  dome  three  tubular  shafts  fifteen  feet  in  length, 
into  which  the  miscellaneous  refuse  wagons  immediately  discharge  their 
contents  from  the  upper  floor  upon  which  they  drive.  Preparatory  to 
the  operation  of  the  furnace,  the  fires  are  started  in  the  primary  and 
secondary  fireplaces,  and  are  maintained  until  a  sufficient  degree  of  heat 
prevails  throughout  the  furnace  and  in  the  superheating  flue  beneath  the 
ash-pit.  I  have  already  emphasized  the  fact  that  animals  are  discharged 
into  the  furnace  nearest  to  the  primary  fire,  while  other  miscellaneous 
material  is  distributed  through  the  small  tubular  flues  along  the  remoter 
portions  of  the  grate.  This  arrangement  contributes  to  the  aid  of  the 
primary  fire,  the  best  fuel-forming  materials  to  be  burned  first,  thus 
diminishing  the  amount  of  fuel  required  to  maintain  the  action  of  the 
furnace.  The  products  of  combustion  are  carried  over  the  grate  and 
thence  over  the  secondary  fire,  burning  at  a  lower  level  at  the  opposite 
end,  and  there  consumed;  thence  any  small  amount  of  remaining  smoke 
or  gas  is  carried  along  through  the  superheated  horizontal  flue,  under¬ 
going  further  combustion,  until  the  chimney  shaft  is  reached.  The 
ashes  of  the  debris ,  falling  through  the  bars  of  the  grate,  light  upon  the 
fire-tiled  floor  of  the  ash-pit,  where  they  are  again  consumed,  while 
liquids,  dropping  upon  it,  are  instantly  evaporated,  and  the  final  ashes 
are  deposited.  The  arrangement  by  which  the  scavengers  dump  directly 
into  the  flues  minimizes  labor  and  insures  greater  cleanliness. 

“  Among  the  questions  likely  to  be  asked  under  this  topic  is  that  which 
relates  to  the  primary  cost  of  construction.  Definite  answers  to  this 
query  cannot  be  given,  for  the  reason  that  with  any  one  of  the  furnaces 

.  8 


CI1 


APPENDIX. 


we  have  described  cost  must  depend  very  largely  upon  location,  avail¬ 
ability  of  materials,  command  of  skilled  labor,  and  the  size  and  capacity 
of  the  furnace  which  the  circumstances  and  extent  of  the  population 
demand.  Equally  important  is  the  question  of  the  cost  of  operation. 
This,  again,  is  insusceptible  of  a  definite  reply.  Location,  available  fuel 
supply,  economical  management  of  the  furnace  fires,  the  class  of  garbage 
or  refuse  to  be  burned,  and  the  proper  disposition  of  fuel-forming  mate¬ 
rials — these  are  all  considerations  which  largely  affect  the  question  of 
working  cost.  The  Mann  furnace  in  Montreal  is  said  to  be  operated  at 
a  cost  of  twenty- five  cents  per  ton  of  miscellaneous  refuse,  and  of 
seventy-five  cents  per  ton  of  night-soil.  It  is  claimed  that  the  Rider 
furnace  will  do  about  the  same  thing. 

“An  estimate  of  the  expenses  of  operating  the  Engle  crematory  in 
Minneapolis  for  a  period  of  five  days,  during  which  the  furnace  was 
worked  by  three  men  entirely  new  to  the  task,  two  of  whom  were  on 
duty  by  day  and  one  by  night,  gives  the  following  facts  and  figures: 

“Consumed  in  five  days:  33  horses,  59  dogs,  103  barrels  of  hotel  and 
commission-house  refuse,  12  loads  of  market  offal  and  70  loads  of  manure, 
weighing,  in  all,  over  200  tons.  Total  cost  of  labor  and  fuel  for  this 
period,  $38.25,  or  $7.65  per  day — the  entire  weight  of  refuse  being 
destroyed  at  a  cost  of  19  cents  per  ton.  The  ash  deposited  in  the  course 
of  the  consumption  of  this  material  is  exceedingly  small  in  quantity, 
weighing  less  than  200  pounds  per  day. 

“This  estimate,  eminently  satisfactory  as  it  is,  is  not  altogether  a  fair- 
one.  The  men  employed  were  wholly  inexperienced.  The  furnace,  at 
the  beginning  of  these  five  days,  was  cold,  and  it  required  several  hours 
to  superheat  it.  The  fuel  used  was  simply  lath  edgings  and  coal  screen¬ 
ings,  or  4  breezed  The  glut  of  horses  was  unusual,  and  crowded  out  the 
ordinary  supply  of  garbage.  It  is  safe  to  say  that  upon  an  average  run, 
over  an  extended  period,  fifteen  to  twenty  cents  per  ton  of  refuse  would 
pay  for  the  labor  employed  and  the  fuel  consumed. 

“  So  far,  then,  as  a  brief  period  of  time  has  permitted  careful  observa¬ 
tion,  the  principal  American  crematories  ma\  be  said  to  have  demon¬ 
strated  their  fitness  for  the  task  of  waste  destruction.  The  possibility 
of  burning  the  refuse  materials  of  a  great  city  without  imposing  upon 
its  people  a  pen.dty  of  insanitary  consequences  in  the  performance  of  the 
;act  has  been  established  beyond  the  shadow  of  a  doubt.  Nuisance  is  far 
more  apt  to  arise  from  mismanagement  in  the  handling  of  the  material 
to  be  burned  than  it  is  likely  to  ensue  from  the  products  of  cremation. 
The  odor  which  arises  from  the  direct  burning  of  night-soil,  even  without 
any  special  precaution  for  the  consumption  of  gases  formed,  is  not  so 
obnoxious  as  might  be  imagined,  resembling  the  smell  of  burned  leather. 
The  commercial  value  of  the  solid  residue  of  combustion  has  yet  to  be 
tested.  It  will  vary,  of  course,  according  to  the  method  of  cremation. 
The  innocuous  character  of  the  ash  must  be  demonstrated  in  each  indi- 


t 


APPENDIX. 


CIII 


vidual  case.  The  only  analysis  of  this  material,  as  produced  by  the 
Minneapolis  crematory,  that  I  have  had  an  opportunity  to  obtain,  has 
beeh  made  within  a  few  days  past  by  Professor  James  A.  Dodge,  Pro¬ 
fessor  of  Chemistry  in  the  Minnesota  State  University.  The  sample 
which  he  examined  was  selected  in  small  quantities  from  different  parts 
of  the  ash-pit,  but  it  was  taken  therefrom  within  a  few  hours  of  the 
initial  starting  of  the  furnace  and  before  the  ash-pit  had  become  thor¬ 
oughly  superheated.  Consequently,  it  may  be  assumed  that  it  contains 
some  proportion  of  organic  matter  wdiich  would  be  consumed  under 
more  average  circumstances. 

“  The  following  is  the  report  of  the  analysis  made  to  me  by  Professor 
Dodge : 

“  ‘  Dr.  S.  S.  Kilvington.  President  of  the  Minneapolis  Board  of  Health: 

“  ‘  Sir:  I  hereby  report  to  you  the  results  of  my  analysis  of  a  sample 
of  ashes  lately  received  from  you. 


Moisture _ _ _ 

Organic  matter . . . 

Sand  and  clay . . — 

Sodium  chloride . . . 

Iron . . . . . . 

Lime,  CaO - - - - - 

Magnesia,  MgO . . . . 

Potassa,  K20 . . . . . . . .  — 

Soda,  Na20 . . . 

Anhydrous  phosphoric  acid,  P205. . . 

Anhydrous  carbonic  acid,  C02 . . . 

Soluble  silica,  S02_ . - . . . 

Sulphur  in  sulphates  and  sulphides . . 

Oxygen  combined  with  part  of  the  iron  and 
part  of  the  sulphur,  and  loss - 


2.82  per  cent. 

10.68 

49.19 

2.83 


1.96 


10.26 


2.68 

2.57 

8.16 

1.49 


1.24 

1.59 


3.75 

100.00 


‘“I  append  the  following  notes  on  the  foregoing  analysis: 

‘•‘The  organic  matter  is  partly  unburned  carbon  and  partly  nitro¬ 
genous  matter,  communicating  considerable  odor  to  the  ashes.  The  iron 
is  probably  mostly  in  the  stat^  of  oxide  of  iron,  but  partly  in  the  state  of 
sulphide  of  iron.  The  latter  gives  some  odor.  The  lime  and  magnesia 
are  mostly  combined  with  the  phosphoric  acid,  making  about  eighteen 
per  cent,  of  phosphates  of  lime  and  magnesia. 

“  ‘The  potassa  is  mostly  combined  with  carbonic  acid.  The  soda  is 
probably  combined  partly  with  carbonic  acid.  The  silica  is  probably 
combined  with  soda  and  some  potassa.  The  sulphur  probably  exists 
mostly  in  sulphate  of  lime.  The  precise  manner  and  proportion  in 
which  the  above  bases  and  acids  are  combined  cannot  be  determined. 

“  ‘  Very  respectfully  yours,  James  A.  Dodge, 

“  ‘  Professor  of  Chemistry .’ 


CIV 


APPENDIX. 


‘  Professor  Dodge  appends  to  his  analysis  the  following  considerations: 

‘‘•It  will  be  seen  that  this  ash  contains  manj  constituent  elements 
which  make  it  of  some  value  as  a  fertilizer.  The  product  of  any  «uch 
furnace,  employed  in  the  destruction  of  animal  and  vegetable  refuse, 
would  be  enhanced  in  value  by  the  admixture  of  the  product  of  a  night- 
soil  crematory.  This  fact  is  illustrated  by  the  management  of  the  Glas¬ 
gow  plant.  I  have  at  hand  samples  of  the  ash  of  the  Engle  crematory 
at  Minneapolis,  which  I  shall  be  happy  to  submit  either  to  the  olfactory 
organs  or  the  chemical  retorts  of  the  members.’” 

The  greatest  defect  in  garbage  removal  in  our  towns  is  the  inadequacy 
of  carts  and  wagons  supplied  for  the  work.  In  most  places,  the  carts 
are  frequently  taken  off  for  grading  or  other  street  work,  and  the  piles  of 
garbage  accumulate  until  its  removal  is  a  matter  of  extremest  difficulty 
and  always  an  offense  to  the  citizens.  In  making  up  estimates  for  towns 
for  the  year,  the  garbage  carts  should  be  amply  provided  for;  they 
should  be  used  for  no  other  purpose;  they  should  be  under  the  control 
of  the  Superintendent  of  Health,  or  sub-officers  of  health  responsible  to 
him  for  their  work.  A  regular  schedule  should  be  devised  for  every  day 
in  the  week,  and  it  should  be  adhered  to,  and  the  people  should  be  made 
acquainted  with  the  rounds  of  the  carts  or  wagons.  The  people  should 
be  required  to  have  their  garbage  ready  for  the  carts  promptly,  and  if 
attended  to  promptly,  it  would  receive  a  very  large  co-operation;  and  in 

cases  of  failure,  which  of  course  there  would  be,  there  could  be  framed 
a  penalty. 


w 


INDEX. 


Page. 

Address  of  welcome  by  Governor  Fowle _ _  7 

Assessment  of  members  of  Association... . .  18 

Bahnson,  Dr.  H.  T. ,  motion  made  by . . . . . .  18 

Paper  read  by . . . . . . . . .  18 

Remarks  made  by . . . . .12,  22 

Chase,  Mr.  J.  C. ,  motion  made  by . . . . . .  11 

Remarks  made  by . . . . . . 20,  22,  26 

Committee  on  Permanent  Oganization . . . . . .  11 

On  Water  Supplies . . . . .  28 

On  Ways  and  Means . . . . .  11 

To  select  delegates  to  Southern  Convention _  16 

To  wait  on  Finance  Committee  of  Senate . . .  22 

Constitution  of  the  Association . . . . . . . .  16 

Curtis,  Dr.  G.  W.,  paper  read  by.. . . . .  13 

Engle  Garbage  Furnace,  explanatory  remarks  concerning,  by  Mr. 

Morse . . . . . . . .  25 

Ennett,  Dr.  W.  T.,  motion  made  by . . . .  16 

Food,  adulteration  of,  remarks  concerning,  by  Prof.  Venable  and 

Dr.  Wood . . . . 20-21 

Funds  of  the  Association  - - - - - - - 18,  26 

Grissom,  Dr.  Eugene,  remarks  by - - 12,  18 

Motions  made  by . . . . . .18,  25 

Insane  Asylum,  members  invited  to  visit . . . .  12 

Jones,  Dr.  J.  W. ,  paper  read  by. - - - - -  12 

Keogh,  Col.  Thos.,  remarks  by . - .  27 

Lewis,  Dr.  R.  H.,  explanatory  address  by . . . .  8 

'Remarks  by. . . . - . .  16 

Ludlow,  Mr.  J.  L.,  paper  read  by . . .  22 

Remarks  made  by . . . . -  - . . . -  -  21 

McDonald,  Dr.  John,  remarks  by . . . . 13,  26 

Officers,  election  of . . . . . - . 10,  11,  18 

List  of . - . . .  2 

O’Hagan,  Dr.,  remarks  by . . . - . —  24 

Motion  made  by . - . . .  18 

Pearsall,  Mr.  Oscar,  motion  made  by. . . . - .  10 

Remarks  by . - . - .  21 

Permanent  Organization,  report  of  Committee  on . . .  16 

Quarantine,  discussion  concerning,  by  Drs.  Lewis,  McDonald  and 

Wood . . . - . . 15 

Resolution  relative  to . . . .  16 


C  VI 


Index. 


Page. 

Sanitary  Convention,  call  for  a . . . . . . .  3 

Sewage,  effect  of,  upon  crops. - - -  23 

Thomas,  Dr.  G.  G. ,  paper  of  (read  by  Dr.  Bahnson) . . . .  15 

Tucker,  Dr.  J.  H.,  motion  made  by . . . . .  12 

Paper  read  by . . . . . . . .  26 

Venable,  Pjof.  F.  P.,  motion  made  by _ _ _ _  28 

Paper  read  by _ _ _ _ _ _  20 

Water,  method  for  purifying _ _ _ _ 18,20 

Water  supplies  _  _ _ _ _ _ _ 19,  26,  27 

Wood,  Dr.  Tlios.  F.,  motions  made  by . . . . 10,  11,  12,  16 

Paper  read  by _ _ _ _  24 

Remarks  by _ _ _ _ _ _ _ 12,  13,  15,  18,  20 

Resolution  offered  by... . . . . .  15 


APPENDIX. 

s 

The  Public  Water  Supply  of  Towns  and  Cities  in  North  Carolina: 

H.  T.  Bahnson,  M.  D.,  Salem. . . . .  1 

Inland  Quarantine:  George  Gillett  Thomas,  M.  D.,  Wilmington,  N.  C.  21 

Maratime  Quarantine:  W.  G.  Curtis,  M.  D.,  Wilmington,  N.  C _  31 

The  Necessity  of  State  Intervention  to  Prevent  Adulteration  of  Food 

and  Drugs:  Prof.  F.  P.  Venable,  Chapel  Hill,  N.  C _  37 

How  can  we  Best  Secure  Economical  Disposal  of  Refuse  in  our 

Towns?  J.  L.  Ludlow.  C.  E.,  Winston,  N.  C_ . .  42 

The  Duties  and  Responsibilities  of  County  Superintendents  of  Health : 

J.  S.  Tucker,  M.  D . . . . . . . .  54 

Some  Gains  from  Sanitation:  J.  W.  Jones,  M.  D. _ _ _  61 

The  Sewerage  of  Cities  and  Towns:  J.  L.  Ludlow,  C.  E.,  M.  S .  66 

How  can  we  Best  Secure  Economical  Disposal  of  Refuse  in  our 
Towns?  Some  Remarks  on  the  Garbage  Furnaces  in  Use:  Dr. 
Thos.  F.  Wood _ _ _ _ _  97 


9 


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1889 


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North  Carolina  Sanitary 
Association 

Report  of  proceedings 


DATE 


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